Análisis del virus papiloma humano (VPH), mediante PCR convencional y Macroarray, en mujeres entre 30 y 50 años de edad con patología cérvico-uterina o sospecha, en el Servicio de Salud Metropolitano Occidente
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Fecha
2010
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Idioma
es
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Universidad Andrés Bello
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Resumen
El Virus Papiloma Humano (VPH) es una de las Infecciones de transmisión sexual más comunes en la actualidad. Investigaciones realizadas en Chile y el mundo demuestran que este es el principal agente etiológico del cáncer cérvicouterino. También se ha estudiado la prevalencia de los subtipos y ésta puede variar entre una población y otra. Se conocen más de 120 subtipos, los cuales se clasifican mediante el grado oncogénico que estos desarrollan, ya sea de alto riesgo (AR) y bajo riesgo (BR). Según diversos artículos los subtipos más comúnmente identificados en lesiones cérvico-uterinas son el 16 y 18, pero cabe destacar que otros subtipos de AR pueden aparecer por sí solos o acompañados de otros de alto o de bajo riesgo y ser responsables de neoplasias cervicales y carcinomas in situ lo cual hace relevante estudiar también la coinfección.
Por esto, en el Servicio de Salud Metropolitano Occidente se realizó una investigación, donde participaron mujeres de 30 a 50 años que fueron derivadas al Servicio por algún tipo de lesión cérvico uterina o sospecha de ello. El objetivo fue realizar un análisis de los subtipos de AR y BR en este sector, porcentualizar las infecciones simples como también las múltiples (coinfección), relacionar los subtipos de virus con las lesiones de alto y bajo grado y asociar los resultados a conductas de riesgo vitales para la adquisición del virus, como son la edad de inicio de relaciones sexuales y el número histórico de parejas sexuales de las pacientes.
Se escogieron mujeres entre 30 y 50 años de edad porque en este rango se observa una mayor relación entre la presencia del virus y lesiones de alto grado.
Para identificar el VPH se utilizaron 2 técnicas de biología molecular, en primer lugar la PCR convencional, método directo, especifico y altamente sensible capaz de detectar la presencia de DNA viral, luego se aplicó la técnica de Macroarray utilizada para tipificar él o los subtipos de virus presentes en las muestras, esto permitió clasificarlos en virus de AR y BR oncogénico. Estos procedimientos ayudaron al clínico, brindando una importante herramienta
de apoyo al diagnóstico que determinó el tipo de tratamiento o seguimiento para la
paciente.
En la población estudiada los subtipos más frecuentes fueron el 16 (30,43%) y el
58 (15,21 %), ambos de AR, además se relacionaron fuertemente subtipos de AR
con lesiones de alto grado (43,47%). Finalmente, sobre los factores de riesgo
incluidos en el estudio se puede deducir que para la adquisición del virus, el más
predominante es la edad de inicio de actividad sexual y para la coinfección el
factor más importante es la cantidad de parejas sexuales a lo largo de la vida.
Human Papilloma Virus (HPV) is one of the most common infections sexually transmitted today. Studies made in Chile and the world, demonstrate that this is the main etiologic agent of cervical cancer. Also has been studied the prevalence of subtypes, which can vary between one population to another. There are more than 120 subtypes, which are classified by the degree oncogenic that they develop in high or low risk. According to various articles the most common subtypes identified in cervical lesions and cancer are 16 and 18, but it is noteworthy that other subtypes of high-risk may appear by themselves (single infection) or with other high or low risk and are responsible for cervical neoplasia and carcinoma in situ as which makes it relevant to study also the co-infection. Because of this, in the Western Metropolitan Health Service research was conducted an investigation, which involved women aged 30 to 50 years who were referred to the Service for any cervical lesion or suspected of it. The purpose was to analyze the subtypes of high and low oncogenic risk HPV in this sector, rebasad simple infections as well as multiple or co~infection, virus subtypes correlata with lesions of high and low grade and associate outcomes and risk behaviors vital to the acquisition of HPV which are the age of onset of sexual relations and the historical number of sexual partners of patients. Women were chosen between 30 and 50 years of age because in this range is a greater relationship between the virus and high-grade lesions. To identify the HPV was used two molecular biology techniques, in the first place the conventional PCR, direct method, specific and highly sensitive capable of detecting the presence of viral DNA, then applied Macroarray technique used to establish he or subtype of virus present in samples, This allowed to classify them in high and low oncogenic risk. This two procedures helped the clinician providing diagnostic support tool very important to determine the type of treatment of monitoring that is done to the patient. In the study population most common subtypes were 16 (30,43%) and 58 (15,21 %), both high risk, also were strongly related high-risk subtypes with highgrade lesions (43,47%). To identify HPV was used two molecular biology techniques, in first place the conventional PCR, direct method, with specific and highly sensitive capable of detecting the presence of viral DNA, then applied the Macroarray technique used to establish he or subtypes virus present in the samples, this allowed to classify them in high and low onGogenic risk. These procedures helped the clinician to provide an important diagnostic tool to support that determined the type of treatment or follow-up to the patient. In the study population most common subtypes were 16 (30.43%) and 58 (15.21 %), both of high risk also was strongly related high risk subtypes with highgrade lesions (43.47%). Finally, it was concluded that the most important risk factor for acquiring the virus was the age of first sexual intercourse and co-infection the most important factor is the number of partners throughout life.
Human Papilloma Virus (HPV) is one of the most common infections sexually transmitted today. Studies made in Chile and the world, demonstrate that this is the main etiologic agent of cervical cancer. Also has been studied the prevalence of subtypes, which can vary between one population to another. There are more than 120 subtypes, which are classified by the degree oncogenic that they develop in high or low risk. According to various articles the most common subtypes identified in cervical lesions and cancer are 16 and 18, but it is noteworthy that other subtypes of high-risk may appear by themselves (single infection) or with other high or low risk and are responsible for cervical neoplasia and carcinoma in situ as which makes it relevant to study also the co-infection. Because of this, in the Western Metropolitan Health Service research was conducted an investigation, which involved women aged 30 to 50 years who were referred to the Service for any cervical lesion or suspected of it. The purpose was to analyze the subtypes of high and low oncogenic risk HPV in this sector, rebasad simple infections as well as multiple or co~infection, virus subtypes correlata with lesions of high and low grade and associate outcomes and risk behaviors vital to the acquisition of HPV which are the age of onset of sexual relations and the historical number of sexual partners of patients. Women were chosen between 30 and 50 years of age because in this range is a greater relationship between the virus and high-grade lesions. To identify the HPV was used two molecular biology techniques, in the first place the conventional PCR, direct method, specific and highly sensitive capable of detecting the presence of viral DNA, then applied Macroarray technique used to establish he or subtype of virus present in samples, This allowed to classify them in high and low oncogenic risk. This two procedures helped the clinician providing diagnostic support tool very important to determine the type of treatment of monitoring that is done to the patient. In the study population most common subtypes were 16 (30,43%) and 58 (15,21 %), both high risk, also were strongly related high-risk subtypes with highgrade lesions (43,47%). To identify HPV was used two molecular biology techniques, in first place the conventional PCR, direct method, with specific and highly sensitive capable of detecting the presence of viral DNA, then applied the Macroarray technique used to establish he or subtypes virus present in the samples, this allowed to classify them in high and low onGogenic risk. These procedures helped the clinician to provide an important diagnostic tool to support that determined the type of treatment or follow-up to the patient. In the study population most common subtypes were 16 (30.43%) and 58 (15.21 %), both of high risk also was strongly related high risk subtypes with highgrade lesions (43.47%). Finally, it was concluded that the most important risk factor for acquiring the virus was the age of first sexual intercourse and co-infection the most important factor is the number of partners throughout life.
Notas
Tesis (Tecnólogo Médico)
Palabras clave
Papillomavirus, Prevención y Control, Cáncer Cervicouterino, Chile, Virus Papiloma Humano, Enfermedades Transmisibles, Región Metropolitana