Existe alteração no mecanismo de adesão celular mediado pela E-caderina nas neoplasias cervicais de pacientes soropositivas para o HIV?

Abstract

PURPOSE: to evaluate the expression of E-cadherin in cervical lesions of patients suffering from HIV infection. METHODS: we conducted a study with 77 patients with cervical HPV infection, 40 of them were HIV seropositive and 37 HIV seronegative who underwent colposcopy and a biopsy of the cervix. The material obtained by biopsy of the cervix was sent for histopathologic and immunohistochemical study. Sections were obtained and mounted on silanized slides and examined by an observer who was blind to patient serology. E-cadherin antibody, clone NHC-38 diluted 1:400 (DAKO) and the Novolink polymer system (Novocastra) were used. The expression of E-cadherin was determined on the epithelial cell membrane based on the extent of the stained area. The χ2 test with Yates correction or the Fisher's Exact test was used for comparison of the proportion in univariate analysis. All the variables with p<0.25 were included in the logistic regression model, called initial model. The analyses were carried out using the SPSS software, with the level of significance set at 5%. RESULTS: the expression of E-cadherin was observed in up to the internal 1/3 of the epithelium in 59.3% of cases and in up to 2/3 of the epithelium in 11.1% of cases, but in 29.6% of cases the expression was identified throughout the thickness of the epithelium in HIV-seronegative patients. In contrast, in HIV-seropositive patients, 45.9% showed expression up to 1/3 of the epithelium, 13.5% showed expression in up to 2/3 of the epithelium, and 40.5% showed expression throughout the thickness of the epithelium. E-cadherin expression did not differ between groups (p=0.5). However, the multivariate analysis identified a significant association between high-grade cervical injury and E-cadherin expression in 2/3 and 3/3 of the epithelium (p=0.001; χ2=36.9). CONCLUSIONS: the expression of E-cadherin in the epithelial cell membrane is not associated with infection by the human immunodeficiency virus, but with the degree of intraepithelial cervical injury.