Christina Cordeiro Benevides de Magalhães1, Iara Moreno Linhares2, Laís Farias Masullo3,4, Renata Mírian Nunes Eleutério4,5, Steven S Witkin6, José Eleutério7,8,9. 1. Master's Program in Pathology, Federal University of Ceará, Fortaleza, Brazil. 2. Department of Gynecology and Obstetrics, São Paulo University Medical School, São Paulo, Brazil. 3. Postgraduate Program in Development and Technological Innovation in Medicines, Federal University of Ceará, Fortaleza, Brazil. 4. UNICHRISTUS University Center, Fortaleza, Brazil. 5. Professor Eleutério Laboratory, Fortaleza, Brazil. 6. Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, USA. 7. Master's Program in Pathology, Federal University of Ceará, Fortaleza, Brazil. prof.eleuterio@gmail.com. 8. Professor Eleutério Laboratory, Fortaleza, Brazil. prof.eleuterio@gmail.com. 9. Bloco Didatico da Faculdade de Medicina/UFC, Rua: Prof. Costa Mendes, 1608, 2nd floor, Fortaleza, 60.430-140, Brazil. prof.eleuterio@gmail.com.
Abstract
PURPOSE: Identification of low-cost protocols to identify women at elevated susceptibility to develop cervical intra-epithelial abnormalities would aid in more individualized monitoring. We evaluated whether quantitation of the D- and L-lactic acid isomers in vaginal secretions could differentiate women with normal cervical epithelia from those with a low (LSIL) or high (HSIL) grade squamous intraepithelial lesion or with cervical cancer. METHODS: Vaginal samples, collected from 78 women undetgoing cervical colposcopy and biopsy, were tested for pH, bacterial composition by Gram stain (Nugent score) and concentrations of D- and L-lactic acid by a colorimetric assay. RESULTS: Subsequent diagnosis was 23 women with normal cervical epithelium, 10 with LSIL, 43 with HSIL and 2 with cervical cancer. Vaginal pH and Nugent score were comparable in all subject groups. The concentration of L-lactic acid, but not D-lactic acid, as well as the L/D-lactic acid ratio, were significantly elevated (p < 0.01) in women with HSIL and cervical cancer. CONCLUSION: Comparative measurement of vaginal D- and L-lactic acid isomers may provide a low-cost alternative to identification of women with an elevated susceptibility to cervical abnormalities.
PURPOSE: Identification of low-cost protocols to identify women at elevated susceptibility to develop cervical intra-epithelial abnormalities would aid in more individualized monitoring. We evaluated whether quantitation of the D- and L-lactic acid isomers in vaginal secretions could differentiate women with normal cervical epithelia from those with a low (LSIL) or high (HSIL) grade squamous intraepithelial lesion or with cervical cancer. METHODS: Vaginal samples, collected from 78 women undetgoing cervical colposcopy and biopsy, were tested for pH, bacterial composition by Gram stain (Nugent score) and concentrations of D- and L-lactic acid by a colorimetric assay. RESULTS: Subsequent diagnosis was 23 women with normal cervical epithelium, 10 with LSIL, 43 with HSIL and 2 with cervical cancer. Vaginal pH and Nugent score were comparable in all subject groups. The concentration of L-lactic acid, but not D-lactic acid, as well as the L/D-lactic acid ratio, were significantly elevated (p < 0.01) in women with HSIL and cervical cancer. CONCLUSION: Comparative measurement of vaginal D- and L-lactic acid isomers may provide a low-cost alternative to identification of women with an elevated susceptibility to cervical abnormalities.
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