Análise da hipermetilação do gene pINK4a em lesões pré-malignas e malignas da cérvice uterina associadas à infecção por papilomavírus humanos

Abstract

pINK4a gene silencing through hypermethylation have been suggested as a cofactor involved in cervical carcinogenesis. We aimed to investigate its methylation status in cervical epithelia and evaluate an association with HPV infection and genotype. This retrospective cross-sectional study was performed with 141 cervical exfoliated cell samples, classified through Bethesda System as Normal (28), low grade intraepithelial lesion (35), high grade intraepithelial lesion (49) and Invasive cancer (29). HPV detection and genotyping was performed through polymerase chain reaction (PCR). Hypermethylation was assessed with nested-methylation specific PCR. To evaluate an association between pINK4a methylation variables such as HPV infection, viral genotyping, tobacco exposure and age a multivariate analysis was performed. HPV positivity was detected in 62% of the samples and 44.6% showed pINK4a hypermethylation. An upward trend was observed according to lesion severity (p<0.001). Multivariate analysis showed an association between high-risk HPV infection and methylated pINK4a profile (p=0.01). We found a correlation between high grade intraepithelial lesion (p=0.007) and cancer (p<0.0001) cytology results and the presence of methylation. Our results point out that pINK4a methylation may contribute to the establishment of premalignant lesions and neoplastic transformation of cervical epithelium along with hr-HPV infection.