International Journal of Reproductive BioMedicine
International Journal of Reproductive BioMedicine
IJRM
Medical Sciences
http://ijrm.ir
1
admin
2476-4108
2476-3772
10.29252/ijrm
en
jalali
1402
3
1
gregorian
2023
6
1
21
6
online
1
fulltext
en
تأثیر عفونتهای مقاربتی بر ناهنجاری های سیتولوژیک دهانه رحم در زنان ایرانی: یک مطالعه مقطعی
Influence of sexually transmitted infections on the cervical cytological abnormalities among Iranian women: A cross-sectional study
Reproductive Oncology
Original Article
Original Article
<div style="text-align: justify;"><span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مقدمه: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">عفونت­های مقاربتی (</span></span><span dir="LTR" style="font-size:10.0pt">STIs</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) یکی از جدی</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">ترین چالش</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">های بهداشتی در جهان هستند. وجود عفونت</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">های مقاربتی مانند ویروس پاپیلومای انسانی (</span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">) ممکن است باعث تغییرات سلولی و نهایتا سرطان دهانه رحم شود.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هدف: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">هدف از این مطالعه بررسی ارتباط عفونتهای مقاربتی با ناهنجاری­های سیتولوژیک دهانه رحم و بروز زگیل تناسلی در زنان شهر مشهد واقع در شمال شرق ایران بود.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مواد و روش­ ها: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">این مطالعه مقطعی بر روی 190 زن از فروردین تا مرداد 1401 که به آزمایشگاه مرکزی جهاد دانشگاهی مشهد مراجعه نمودند، انجام شد. وجود عفونتهای تناسلی ناشی از کلامیدیا تراکوماتیس، نایسریا گونوره، مایکوپلاسما ژنیتالیوم و هرپس­سیمپلکس (1 و 2) با روش </span></span><span dir="LTR" style="font-size:10.0pt">Real-time PCR</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مورد بررسی قرار گرفت. عفونت تناسلی </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">با استفاده از روش هیبریداسیون معکوس و تغییرات سلولی دهانه رحم با تکنیک سیتولوژی مبتنی بر مایع مورد بررسی قرار گرفت.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتایج: </span></span></b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">میانگین سنی شرکت­کنندگان 9/8 </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"Cambria","serif"">± </span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">33/35 سال بود. در افراد</span></span> <span dir="LTR" style="font-size:10.0pt">HPV</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">مثبت، 34 ژنوتیپ مختلف</span></span> <span dir="LTR" style="font-size:10.0pt">HPV</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">شناسایی شد و شایع</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">ترین ژنوتیپ</span></span> <span dir="LTR" style="font-size:10.0pt">HPV6</span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">از گروه کم</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">خطر بود. ارتباط معنی</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">داری بین عفونت</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">های مقاربتی (</span></span><span dir="LTR" style="font-size:10.0pt">STIs</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">)</span></span> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">و ناهنجاری­های سیتولوژیک دهانه رحم یافت نشد</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">.</span></span><span style="font-size:11.0pt"><span style="font-family:"B Mitra""> میزان شیوع پاتوژن­های مقاربتی در بیماران </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مثبت و </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> منفی به ترتیب 9/10 و 6/1 درصد بود. فراوانی زگیل تناسلی در افرادی که همزمان به ژنوتیپهای پرخطر و کم</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">خطر </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> مبتلا بودند، بهطور معنیداری بیشتر بود.</span></span></span></span></span></span></span><br>
<span style="font-size:12pt"><span style="text-justify:inter-ideograph"><span style="direction:rtl"><span style="unicode-bidi:embed"><span style="font-family:"Times New Roman","serif""><b><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">نتیجه­ گیری:</span></span></b> <span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">درصد بالایی از شرکتکنندگان که مبتلا به </span></span><span dir="LTR" style="font-size:10.0pt">STIs</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> و </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> بودند از نظر سیتولوژی دهانه رحم طبیعی بودند. بنابراین توصیه می</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">شود جهت غربالگری سرطان دهانه رحم از تست</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif"">­</span></span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra"">های تشخیصی </span></span><span dir="LTR" style="font-size:10.0pt">STIs</span><span style="font-size:11.0pt"><span style="font-family:"B Mitra""> و </span></span><span dir="LTR" style="font-size:10.0pt">HPV</span><span lang="FA" style="font-size:11.0pt"><span style="font-family:"B Mitra""> به همراه بررسی سیتولوژیک دهانه رحم استفاده شود.</span></span><span dir="LTR" style="font-size:11.0pt"><span style="font-family:"Arial","sans-serif""></span></span></span></span></span></span></span><br>
</div>
<div style="text-align: justify;"><span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Background: </span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Sexually transmitted infections (STIs) are one of the world's most severe health challenges. The existence of STIs such as human papillomavirus (HPV) might cause cervical cell changes leading to cervical cancer. </span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Objective: </span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">This study aims to assess the association of STIs with cervical cytological abnormalities and genital warts among women in northeastern Iran.</span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Materials and Methods: </span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">This cross-sectional study was carried out on 190 women referred to </span></span><span lang="EN" style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">the central laboratory of </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Academic Center for Education, Culture, and Research, Mashhad, Iran from March to July 2022.</span></span> <span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">The presence of genital infections caused by <i>Chlamydia trachomatis</i>, <i>Neisseria gonorrhoeae</i>, <i>Mycoplasma genitalium</i>, and Herpes simplex viruses (1 and 2) were assessed using the real-time polymerase chain reaction method<span style="background:white">.</span> HPV genital infection was detected based on the principles of reverse hybridization, and cellular changes in the cervix were examined by the liquid-based cytology technique. </span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Results: </span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">The mean age of participants was 35.33 ± 8.9</span></span> <span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">yr. 34 different HPV genotypes were detected in all HPV-positive cases, and the most common genotype was low-risk HPV6. No significant association was found between STIs and cervical cytology abnormalities. The prevalence rates of sexually transmitted pathogens among HPV-positive and HPV-negative individuals were 10.9 and 1.6%, respectively. </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">The frequency of genital warts was significantly higher in cases with multiple infections of high- and low-risk HPV genotypes. </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""></span></span></span></span></span><br>
<span style="font-size:11pt"><span style="line-height:normal"><span style="font-family:Calibri,"sans-serif""><b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">Conclusion: </span></span></b><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">High percentages of the participants with non-HPV STIs and HPV infection had normal cervical cytology. It is advised to use </span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif"">STIs</span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman","serif""> and HPV diagnostic tests along with cytology examinations for cervical cancer screening.</span></span></span></span></span></div>
عفونت های مقاربتی, ویروس پاپیلومای انسانی, سرطان دهانه رحم, زگیل تناسلی, ژنوتیپ ها.
HPV, other STIs and cervical cytological abnormalities
491
498
http://ijrm.ir/browse.php?a_code=A-10-2392-1&slc_lang=en&sid=1
Azam
Shafaei
Azam.shafaee@gmail.com