Cortés GEI, Witvrun ÁJN, Sánchez RG, Gaspar BJA, Hernández GF, Cerda FRM

Language: Spanish
References: 13
Page: 111-116
PDF size: 57.14 Kb.

ABSTRACT

Objectives: 1) To determinate the presence of human papillomavirus (HPV) in women with cervical condylomas after the trichloroacetic acid application by the polymerase chain reaction (PCR) test, and 2) to validate the colposcopy test versus the PCR (gold standard).
Patients and methods: A selected sample of 28 women of 18 to 45 years old with cervical condyloma acuminate, without evidence of cervical neoplasic lesion and with positive diagnosis of HPV with PCR was included. b-globin gene was used as internal control and as DNA integrity marker. Women included in this study were divided in: treated group (n = 14), which were treated just one time with trichloroacetic acid to 90% in the cervix, the cul de sacs and the vagina areas, and placebo group (n = 14), which were treated with physiological saline. After eight weeks of being applied the treatment, each one of the 28 women was HPV diagnosed again by colposcopy and PCR.
Results: All women amplified for the b-globin gene. In the treated group, 11/14 (78%) patients did not show amplification. The colposcopy showed two negative false, five positive false, one positive true and six negative true tests, revealing sensitivity of 33.33% and specificity of 54.54%.
Conclusions: From the molecular point of view, this study showed that the trichloroacetic acid application causes physical destruction of the infected tissue, without detecting DNA damage due to the cellular desquamation. On the other hand, the colposcopy regarding the PCR is not an appropriate test for the diagnosis and follow-up of the HPV infection.

REFERENCES

1. Muñoz N, Bosch F. Cervical cancer and human papillomavirus: epidemiological evidence and perspectives for prevention. Salud Publica Mex 1997;39:274-82.

2. Lee SS, Collins RJ, Pun TC, Cheng DK, Ngan HY. Conservative treatment of low grade squamous intraepithelial lesions (LSIL) of the cervix. Int J Gynaecol Obstet 1998;60:35-40.

3. Russomano F, Reis A, de Camargo MJ, Peixoto-Dutra MV, Costa-Fonseca S, Anderson J. Efficacy in treatment of subclinical cervical HPV infection without intraepithelial neoplasia: systematic review. Sao Paulo Med J/Rev Paul Med 2000;118:109-15.

4. Gross G. Clinical aspects and therapy of anogenital warts and papillomatosis-associated lesions. Hautarzt 2001;52:6-17.

5. Walker P, Dexeus S, de Palo G, Barrasso R, Campion M, Girardi F, et al. International terminology of colposcopy: an updated report from the International Federation for Cervical Pathology and Colposcopy. Obstet Gynecol 2003;101:175-7.

6. Bauer H, Greer C, Manos M. Detection of human papillomavirus infection using PCR. In: Herrington CS, McGee JO, editors. Diagnostic molecular pathology: a practical approach. Oxford: Oxford University Press, 1992;pp:131-52.

7. Zhu WY. Detection with the polymerase chain reaction of human papillomavirus DNA in condylomata acuminate treated in vitro with liquid nitrogen, trichloroacetic acid, and podophyllin. J Am Acad Dermatol 1993;26:710-4.

8. Gal D. Transmissibility and treatment failures of different types of human papillomavirus. Obstet Gynecol 1989;73:308-10.

9. Boothby RA, Carlson JA, Rubin M. Single application treatment of human papillomavirus infection of the cervix and vagina with trichloroacetic acid. Obstet Gynecol 1990;76:278-80.

10. Lie AK, Skjeldestad FE, Hagen B, Johannessen E, Skarsvag S, Haugen A. Comparison of light microscopy in situ hybridization and polymerase chain reaction for detection of human papillomavirus in histological tissue for cervical intraepithelial neoplasia. APMIS 1997;105:115-20.

11. Gjoen K, Satter T, Olsen AO, Orstavik I. Correlation between polymerase chain reaction and cervical cytology for detection of human papillomavirus in histological tissue of cervical intraepithelial neoplasia. APMIS 1997;105:71-75.

12. Méndez-Velásquez JF, González-Sánchez JL, Rodríguez-de Santiago JD. Tratamiento de la infección cervical por el virus del papiloma humano con ácido tricloroacético. Ginecol Obstet Mex 1993;61:48-51.

13. Malviya VK, Deppe G, Pluszczynski R, Boike G. Trichloroacetic acid in the treatment of human papillomavirus infection of the cervix without associated dysplasia. Obstet Gynecol 1987;70:72-74.