[Interest in visual inspection with acetic acid and Lugol iodine with colposcope in screening of cervical lesions in Gabon]

Introduction

Au Gabon, le dépistage des lésions précancéreuses et cancéreuses du col de l'utérus n'est pas systématique. La vulgarisation de ce dépistage suppose l'utilisation d'un test efficace et adapté aux réalités locales.

Méthodes

L'objectif de cette étude était de comparer les performances du frottis cervico-vaginal (FCV) conventionnel et de l'inspection visuelle à l'acide acétique (IVA) et au soluté de Lugol (IVL) couplée à la colposcopie, dans la détection des lésions du col utérin au Gabon. Des tests IVA/IVL et FCV ont été effectués chez 309 femmes gabonaises âgées de 18 à 75 ans. Des biopsies ont été réalisées en cas de résultat positif.

Résultats

5 cancers épidermoïdes (1,6%) et 4 lésions précancéreuses (1,3%) ont été confirmées par l'histologie. L'IVA/IVL a présenté une meilleure sensibilité (100%) que le FCV (89%). Toutefois, le FCV est apparu plus spécifique (100% versus 92%). Avec une valeur prédictive (VP) négative de 100%, l'IVA/IVL a permis d'exclure avec certitude la présence de cancer du col lorsque le résultat était négatif, contrairement au FCV (92%). L'IVA/IVL et le FCV ont présenté des VP positives respectivement de 90% et 100%.

Conclusion

Cette étude montre que l'IVA/IVL avec colposcope couplée à l'histologie en cas de résultat positif apparaît plus performante que le FCV.

Fine temporal analysis of DHT transcriptional modulation of the ATM/Gadd45g signaling pathways in the mouse uterus

In rodents, the uterus of a mature female undergoes changes during the uterine cycle, under the control of steroid hormones. 5alpha-Dihydrotestosterone (DHT) is recognized to play an important role in the regulation of androgen action in normal endometrium. Using microarray technology, a screening analysis of genes responding to DHT in the uterus of ovariectomized mice, has allowed us to highlight multiple genes of the ATM/Gadd45g pathway that are modulated following exposure to DHT. Two phases of regulation were identified. In the early phase, the expression of genes involved in the G2/M arrest is rapidly increased, followed by the repression of genes of the G1/S checkpoint, and by the induction of transcriptional regulators. Later, i.e. from 12 to 24 hr, genes involved in G2/M transition, cytoarchitectural and lipid-related genes are stimulated by DHT while immunity-related genes appear to be differentially regulated by the hormone. These results show that a physiological dose of DHT induces the transcription of genes promoting the cell cycle progression in mice. Profile determination of temporal uterine gene expression at the transcriptional level enables us to suggest that the DHT modulation of genes involved in ATM/Gadd45g signaling in an ATM- or p53-independent manner, could play an important role in the cyclical changes of uterine cells in the mouse uterus.

Temporal analysis of E2 transcriptional induction of PTP and MKP and downregulation of IGF-I pathway key components in the mouse uterus

17beta-Estradiol (E2) is well known to be associated with uterine cancer, endometriosis, and leiomyomas. Although insulin-like growth factor I (IGF-I) has been identified as a mediator of the uterotrophic effect of E2 in several studies, this mechanism is still not well understood. In the present study, identification of the genes modulated by a physiological dose of E2, in the uterus, has been done in ovariectomized mice using Affymetrix microarrays. The E2-induced genomic profile shows that multiple genes belonging to the IGF-I pathway are affected after exposure to E2. Two phases of regulation could be identified. First, from 0 to 6 h, the expression of genes involved in the cell cycle, growth factors, protein tyrosine phosphatases, and MAPK phosphatases is quickly upregulated by E2, while IGF-I receptor and several genes of the MAPK and phosphatidylinositol 3-kinase pathways are downregulated. Later, i.e., from 6 to 24 h, transporters and peptidases/proteases are stimulated, whereas defense-related genes are differentially regulated by E2. Finally, cytoarchitectural genes are modulated later. The present data show that a physiological dose of E2 induces, within 24 h, a series of transcriptional events that promote the uterotrophic effect. Among these, the E2-mediated activation of the IGF-I pathway seems to play a pivotal role in the uterotrophic effect. Furthermore, the protein tyrosine phosphatases and MAPK phosphatases are likely to modulate the estrogenic uterotrophic action by targeting, at different steps, the IGF-I pathway.