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Instituto Nacional de Salud Pública

2005, Número 5

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salud publica mex 2005; 47 (5)


Factores de riesgo de cáncer cervicouterino invasor en mujeres mexicanas

Tirado-Gómez LL, Mohar-Betancourt A, López-Cervantes M, García-Carrancá A, Franco-Marina F, Borges G

Idioma: Español
Referencias bibliográficas: 41
Paginas: 342-350
Archivo PDF: 142.79 Kb.


RESUMEN

Objetivos. Evaluar la asociación entre cáncer cervicouterino (CaCu) invasor y el virus del papiloma humano de alto riesgo (VPH-AR) (carga viral/tipo 16), así como con factores ginecológicos y socioeconómicos. Material y métodos. Estudio de casos y controles pareado individualmente (215 casos con CaCu invasor y 420 controles). La población de estudio se reclutó entre los años 2000 y 2001. Se evaluaron variables tradicionalmente asociadas con CaCu (ginecológicas y socioeconómicas) y dos variables asociadas con la presencia de VPH (carga viral y el tipo 16). La presencia de VPH-AR se determinó mediante Captura de Híbridos II. La carga viral se midió a través de unidades relativas de luz y picogramos por ml (1 RLU=1 pg/ml), divididas en cuatro categorías: negativa (‹1 pg/ml), baja carga viral (1-49 pg/ml), carga viral intermedia (50-499 pg/ml) y alta carga viral (›499 pg/ml). El análisis estimó razones de momios (RM) ajustadas a través de modelos de regresión logística condicionada. Resultados.La presencia de VPH-AR incrementa en 78 veces la probabilidad de presentar CaCu invasor; cuando el VPH es tipo 16, el incremento es mayor (RM= 429.7) comparado con otros tipos (RM=64.1). Se observó una tendencia importante en la RM al elevarse la carga viral (RM=46.6 carga baja; RM=250.7 intermedia y RM=612.9 alta). Finalmente, los factores demográficos y obstétricos conocidos, incrementaron la probabilidad de CaCu invasor. No se observó asociación entre CaCu invasor y tabaquismo en la población de estudio. Conclusiones. Este estudio contribuye a la identificación de las mujeres con alto riesgo de desarrollar CaCu invasor, entre las pacientes infectadas con VPH-AR. Por otra parte, confirma la importancia de la infección de VPH-AR y refleja la carga viral del VPH-AR como cofactor y posible promotor en el desarrollo de la enfermedad. Por último, este biomarcador puede contribuir a mejorar la prevención y la detección temprana de esta enfermedad.


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