Downregulation of IL-2 and IL-23 in Cervical Biopsies of Cervical Intraepithelial Lesions: A Cross-Sectional Study

Introduction: Persistent infection with high-risk human papillomavirus (HPV) types is associated with high-grade intraepithelial lesions (HSILs) and invasive cervical cancer. The host immune response plays a key role in whether HPV clears or persists. Most studies on local immune response to HPV collect cervical mucus in order to quantify secreted cytokines; however, cells located inside the tissue can release different cytokines associated with HPV infection. Objective: This study compared the cytokine levels in cervical biopsy specimens of women with abnormal colposcopic findings according to the histopathological results: low-grade intraepithelial lesion (LSIL), HSIL, and no intraepithelial lesion (NSIL). Methods: A cross-sectional study enrolling 141 cervical biopsy specimens examined the cytokine profile for interleukin (IL-) 2, IL-4, IL-10, IL-12, IL-17, and IL-23 and interferon-γ, using the Luminex assay/ELISA. Differences in cytokine levels among the cervical lesion groups were assessed using the Kruskal-Wallis test. Results: The 141 specimens included 90 HSILs, 22 LSILs, and 29 NSILs. IL-2 levels were significantly higher in NSIL samples than in LSIL or in HSIL samples (p = 0.0001) and IL-23 levels were significantly higher in NSIL than in HSIL samples (p = 0.003). Conclusions: Our study shows that in samples from the lesion site point, 2 important pro-inflammatory cytokines, IL-2 and IL-23, are downregulated in HPV lesions.

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Multiple types of human papillomavirus infection and anal precancerous lesions in HIV-infected men in Taiwan: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2017-019894 ◽

2018 ◽

Vol 8 (1) ◽

pp. e019894 ◽

Cited By ~ 6

Author(s):

Shu-Hsing Cheng ◽

Kuo-Sheng Liao ◽

Chi-Chao Wang ◽

Chien-Yu Cheng ◽

Fang-Yeh Chu

Keyword(s):

Human Papillomavirus ◽

Cross Sectional Study ◽

Low Grade ◽

Sectional Study ◽

Squamous Intraepithelial Lesions ◽

Cross Sectional ◽

Anal Cytology ◽

Hpv Types ◽

The Relationship ◽

Intraepithelial Lesions

ObjectivesThis study aimed to assess the relationship between infection with multiple human papillomavirus (HPV) types and abnormal anal cytology in HIV-infected men.DesignAn observational, cross-sectional study.SettingA regional referral hospital in Taiwan.ParticipantsIn total, 714 HIV-infected men were enrolled between March 2011 and June 2016. Thin preparation anal Pap smears were interpreted according to the 2001 Bethesda System. Thirty-seven types of HPV were detected by reverse line blotting, including 13 oncogenic types and 24 non-oncogenic types.Outcome measuresThe relationship between anal HPV infection and abnormal anal cytology in people of Asian ethnicity and the coverage efficacy in HPV-vaccinated HIV-infected men.ResultsOn anal cytology, 175 (24.5%) subjects had atypical squamous cells of undetermined significance (ASCUS) or higher grades of dysplasia, including 87 (49.7%) with ASCUS, 73 (41.7%) with low-grade squamous intraepithelial lesions (LSILs) and 15 (8.6%) with high-grade squamous intraepithelial lesions (HSILs). A higher proportion of subjects with those without LSIL/HSIL (93.1% vs 67.3%, P<0.0001) had multiple HPV types. The odds of having LSIL/HSIL increased with an increasing number of HPV types: the ORs ranged from 1 for no HPV types to 6.96 (95% CI 2.38 to 20.37) for more than five types (Ptrend<0.0001). Multivariate logistic regression analysis showed a significant association between LSIL/HSIL and the number of HPV genotypes present (OR 1.20; 95% CI 1.02 to 1.42, P<0.05). HPV types covered by the nonavalent HPV vaccine (types 6/11/16/18/31/33/45/52/58) were detected in 70.1% of the patients in this study.ConclusionsThe odds of having anal LSIL/HSIL are approximately seventimes greater in HIV-infected men with than withoutsix or more types of HPV. Multiple HPV types in HIV-infected patients deserves aggressive follow-up, and HPV vaccination programme require scaling up.

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Negative Histology in Cervical Specimens Obtained With the “see and Treat” Method in Women at a Referral Center in Rio De Janeiro, Brazil – A Cross-sectional Study

10.21203/rs.3.rs-34415/v1 ◽

2020 ◽

Author(s):

Renata Pereira Teodoro ◽

Danielle Scherrer ◽

Maria José de Camargo ◽

Ana Costa ◽

Cecília Vianna de Andrade ◽

...

Keyword(s):

Cross Sectional Study ◽

Low Grade ◽

Statistical Association ◽

Sectional Study ◽

Squamous Intraepithelial Lesion ◽

Cross Sectional ◽

Significant Downward Trend ◽

Intraepithelial Lesion ◽

Preinvasive Lesion ◽

Over Time

Abstract Background According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction, and age 25 years or older should be treated at the first visit (“see and treat – S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. This study aimed to measure the negative histology rate in women submitted to S&T according to the Brazilian Guidelines. Methods This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: HPV without CIN, inflammatory, low-grade squamous intraepithelial lesion (LSIL), and CIN 1. Results Of the 616 women, there were 52 (8.44% − 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and younger ages or a significant downward trend over time. Conclusion The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

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Negative histology in cervical specimens obtained with the "see and treat" method among women at a referral center in Rio de Janeiro, Brazil: a cross-sectional study

BMC Women s Health ◽

10.1186/s12905-021-01552-6 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Renata Pereira Teodoro ◽

Danielle Scherer ◽

Maria José de Camargo ◽

Ana Carolina Carioca da Costa ◽

Cecília Vianna de Andrade ◽

...

Keyword(s):

Cervical Cancer ◽

Cross Sectional Study ◽

Cervical Cancer Prevention ◽

Low Grade ◽

Sectional Study ◽

Extensive Experience ◽

Cross Sectional ◽

Referral Center ◽

Significant Downward Trend ◽

Intraepithelial Lesion

Abstract Background According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction and age 25 years or older should be treated at the first visit (“see and treat—S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate. Methods This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: human papillomavirus without cervical intraepithelial neoplasia (CIN), inflammatory, low-grade squamous intraepithelial lesion, and CIN 1. Results Of the 616 women, there were 52 (8.44%, 95%CI 6.25–10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and age or a significant downward trend over time. Conclusion The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

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Performance of OncoE6TMCervical Test in detecting cervical precancer lesions in HIV-positive women attending an HIV clinic in Bujumbura, Burundi: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-029088 ◽

2019 ◽

Vol 9 (9) ◽

pp. e029088

Author(s):

Zacharie Ndizeye ◽

Sonia Menon ◽

Jean-Pierre Van Geertruyden ◽

Catherine Sauvaget ◽

Y Jacquemyn ◽

...

Keyword(s):

Low Income ◽

Cross Sectional Study ◽

Hiv Positive ◽

Low Grade ◽

Sectional Study ◽

Squamous Intraepithelial Lesion ◽

Cross Sectional ◽

Predictive Values ◽

Hiv Positive Women ◽

Intraepithelial Lesion

ObjectiveNew rapid and low-cost molecular tests for cervical cancer screening, such as the OncoE6 Cervical Test, are emerging and could be alternatives for low-income and middle-income countries. To this end, we evaluated the clinical performance of the OncoE6 Cervical Test in detecting cervical intraepithelial neoplasia (CIN) among HIV-infected women in Bujumbura, Burundi.MethodsFrom June to December 2017, a cross-sectional study was conducted in 680 HIV-positive women at the University Hospital. Women aged 25–65 years who declared having had vaginal intercourse were consecutively recruited, and cervical specimens for OncoE6, liquid-based cytology and human papillomavirus (HPV) genotyping were obtained and visual inspection with acetic acid performed. Thereafter, participants underwent a colposcopic examination. The sensitivity, specificity, and positive and negative predictive values of the different tests were calculated with reference to ‘colposcopic-histological’ diagnoses, and areas under the receiver operating curves of OncoE6 and cytology tests were compared.ResultsThe prevalence of CIN was 4.9%, and OncoE6 positivity was 3.1%. OncoE6 sensitivity varied from poor to low with increasing disease severity (42.1%, 95% CI 19.9% to 64.3% at CIN2+ threshold; and 58.3%, 95% CI 30.4% to 86.2% at CIN3+ threshold). OncoE6 had the highest specificity compared with all other tests used together. The performance of the OncoE6 test was significantly lower compared with cytology at atypical squamous cell of undetermined significance (ASCUS+) cut-off (AUC=0.68 vs 0.85, p=0.03) and low-grade squamous intraepithelial lesion (LSIL+) cut-off (AUC=0.68 vs 0.83, p=0.04) for CIN2+ diagnoses. However, the performance of the OncoE6 test was similar to that of cytology at high-grade squamous intraepithelial lesion (HSIL+) cut-off (AUC=0.68 vs 0.76; p=0.30) for CIN2+ diagnoses and was also similar to that of cytology at all cut-offs (ASCUS+, LSIL+ and HSIL+) for CIN3+ diagnoses (p1=0.76, p2=0.95 and p3=0.50, respectively).ConclusionThe current OncoE6 test proved to be a point-of-care test. However, given its poor performance for CIN2+ diagnoses, we do not recommend it for primary screening. We recommend to enrich it with more oncogenic HPV types, which may improve the performance of the test akin to that of cytology.

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Atypical Squamous Cells: Cytopathological Findings and Correlation with HPV Genotype and Histopathology

Acta Cytologica ◽

10.1159/000489386 ◽

2018 ◽

Vol 62 (5-6) ◽

pp. 386-392 ◽

Cited By ~ 3

Author(s):

Geilson Gomes de Oliveira ◽

Judite Maria da Silva Costa de Oliveira ◽

Renata Mirian Nunes Eleutério ◽

Rita de Cássia Carvalho Barbosa ◽

Paulo Roberto Carvalho de Almeida ◽

...

Keyword(s):

Giant Cells ◽

Cross Sectional Study ◽

High Grade ◽

Sectional Study ◽

Squamous Intraepithelial Lesion ◽

Cross Sectional ◽

Atypical Squamous Cell ◽

Squamous Cells ◽

Intraepithelial Lesion ◽

Intraepithelial Lesions

Objective: We aimed to assess potential associations between atypical squamous cell (ASC) subgroups: ASC-US (undetermined significance) and ASC-H (cannot exclude high-grade squamous intraepithelial lesion), regarding cytomorphological features, high-risk (HR) human papillomavirus (HPV) testing, and histological outcomes in a sample of Brazilian women. Study Design: Cross-sectional study which evaluated 1,346 liquid-based cytologies between January 2010 and July 2016 with ASC results. ASC-US and ASC-H were analyzed for frequency, diagnostic criteria, and cytological findings and compared with HR-HPV tests and histological outcomes. Results: Enlarged nucleus was the most frequent ASC-US criterion, but alternative criteria were present in 20% of the total cases. No ASC-US criteria were associated with histological outcomes or HR-HPV positivity. Parakeratosis, corneal pearl, giant cells, and binucleation were strongly associated with ASC-US while hyperkeratosis was associated with high-grade squamous intraepithelial lesions (HSIL) or a superior outcome. HR-HPV was positive in 64.39% of ASC-US and 65.38% of ASC-H. HSIL or superior outcomes also occurred in 13.33% of ASC-US and 64.71% of ASC-H cases. Conclusion: Alternative criteria for ASC-US were relatively frequent. Reactive cellular changes suggestive of atypias were more abundant in ASC-US. Although ASC-H is associated with worse histological outcomes, no differences in HPV positivity were found in comparison to ASC-US.

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Negative histology in cervical specimens obtained with the “see and treat” method in women at a referral center in Rio de Janeiro, Brazil – a cross-sectional study

10.21203/rs.3.rs-34415/v2 ◽

2020 ◽

Author(s):

Renata Pereira Teodoro ◽

Danielle Scherrer ◽

Maria José de Camargo ◽

Ana Costa ◽

Cecília Vianna de Andrade ◽

...

Keyword(s):

Cervical Cancer ◽

Cross Sectional Study ◽

Cervical Cancer Prevention ◽

Low Grade ◽

Sectional Study ◽

Extensive Experience ◽

Cross Sectional ◽

Referral Center ◽

Significant Downward Trend ◽

Intraepithelial Lesion

Abstract Background: According to the Brazilian Guidelines on Cervical Cancer Screening, women with cytopathologic diagnosis of high-grade intraepithelial lesion, abnormal colposcopic findings, fully visible squamocolumnar junction, and age 25 years or older should be treated at the first visit (“see and treat – S&T”). The main limitation to this approach is the risk of overtreatment, identified by histology without preinvasive lesion. The objectives of this study were to identify the overtreatment rate in women undergoing S&T in cervical cancer prevention at a referral center with extensive experience with the method and to detect possible factors associated with this rate.. Methods: This was a cross-sectional study that analyzed records from a database with 616 women submitted to S&T from 1996 to 2017. Negative histology was defined as the following histopathologic results: human papillomavirus (HPV) without Cervical Intraepithelial Neoplasia (CIN), inflammatory, low-grade squamous intraepithelial lesion (LSIL), and CIN 1. Results: Of the 616 women, there were 52 (8.44% - 95%CI 6.25 – 10.64%) with a histopathologic report without preinvasive cervical lesion. No statistical association was found between this outcome and age or a significant downward trend over time.Conclusion: The overtreatment rate in this study can be considered low and consistent with the acceptable rates reported in the literature, reinforcing the prevailing Brazilian guideline, in which the benefits of immediate treatment outweigh the risk of losses following biopsy.

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