Análise do risco de neoplasia intraepitelial cervical com base na associação entre a microbiota local e infecção pelo papilomavírus humano em cidade do interior de minas gerais

Abstract

NTRDUCTION: Human papillomavirus (HPV) infection can result in proliferative and neoplastic epithelial lesions in the cervix. The female genital region is colonized by microorganisms essential for local immunity, but the alteration of this flora has the potential to favor the appearance of HPV--associated lesions. OBJECTIVES: To identify the frequency of uterine cytopathological alterations caused by HPV, and its correlations with the local microbiota modifications. METHODS: Transversal,retrospective and observational study, in which 5.907 cytopathological reports were extracted and analyzed from the Barbacena`s Uterine Cervix`s Information System (July/2015 to June/2016). The study focused on the data from the “Microbiology” and “Squamous cell`s atypia” variables taken from the descriptive diagnosis section within the form. RESULTS: The frequency of HPV related cell`s alteration was 2,5%, including Intraepithelial Cervix’s Neoplasia (ICN) and Atypical Cells of Undetermined Significance. These findings, when associated with metaplasia, had a bigger prevalence between the ages from 11-29 years old. Regarding the microbiota, the presence of HPV related injuries was lower in the group of women colonized by Lactobacillus sp. (RR= 0,54), while in the group colonized by supracytoplasmic bacillus it was higher (RR= 2,13). Moreover, the use of anticonception hormones (RR= 1,42), the presence of clinical signs suggesting Sexual Transmitted Disease (RR= 3,04) and uterine cervix`s squamous cell metaplasia (RR= 5,85) were more frequent within the patients with cytology suggesting HPV infection. CONCLUSIONS: Our study found a frequency of 2,5% colpocitopathological alterations related to HPV infection. Therefore, we identified the presence of Lactobacillus sp as a protective factor against the development of these lesions. On the other hand, the supracytoplasmic bacillus infection was shown to be a risk factor for them.