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Precancerous and cancerous lesions of the uterine cervix are known to be associated with Human Papillomavirus (HPV) infection. The screening of high-risk (HR)-HPV infection in the female population has led to the discovery of several cases of a double cervix, a congenital malformation that is very rare. The purpose of this study was to evaluate HR-HPV infections in women with a double cervix within the National Cervical Cancer Screening program of the Lazio region (Italy). From June 2021 to March 2024, a total of 142,437 samples were analyzed by Seegene's Anyplex TM II HR-HPV method, which identifies 14 HR-HPV genotypes. For each woman identified with a double cervix, two separate samples were taken from both cervices and analyzed separately. Twenty-seven women with a double cervix were identified (0.019%): 23 women were tested as negative for both cervices, while the remaining four (namely A, B, C, and D) resulted positive. By genotyping, the following results were obtained: (A) Both samples showed genotype 31; (B) one cervix was negative while the other showed genotype 58; (C) one cervix was positive for HPV 18 and 31 while for 18, 31, and 33 in the other; and (D) one cervix showed genotype 66 while the other carried the 66 and 68 genotypes. Double cervix is a very rare condition where the presence of HR-HPV genotypes is not homogeneous. As already described, our study confirms that different genotypes can be detected in double cervix malformation, suggesting the need to perform HPV screening on brushing samples from both cervices.

Hepatitis C virus (HCV) genotyping is very useful for identifying the patients (type 1 and 4) that need more aggressive management. In recent years, genotype 4 has shown spread in different parts of Europe. The aim of this study was to update on the prevalence of HCV genotypes of 288 patients in Central Italy, to analyze the possible increase of genotype 4 and to evaluate a new simple genotyping method. A line-probe assay (LiPA, Bayer) was used based on the reverse hybridization of HCV genome fragments previously amplified and biotinylated by a polymerase chain reaction (PCR) assay, COBAS System Amplicor HCV monitor version 2.0 (Roche) or previously amplified by COBAS Ampliprep/TaqMan HCV test (Roche). This last method uses non-biotin-labeled primers, therefore we added for each sample 10 microl of amplified HCV products, 10 microl of denaturation solution and 10 microl of biotinylated-nested primers (Bayer) to utilize the genotyping procedure previously used. The results showed that the prevalence of type 1, 2 and 3 (482, 34.6 and 10.5%, respectively) as well as the prevalent subtypes, 1b and 2a/2c (30.7 and 27.2%, respectively) were similar to previous data. Type 1 and 2 were statistically associated with an older group of patients when compared with type 3 and 4 (p < 0.001). Type 3 and 4 showed a significant prevalence of male patients compared to type 1 and in particular to type 2 (p < 0.014). The prevalence of type 4 was 5.6% in 2004, 6.1% in 2005 and 9.9% from January to July 2006. Type 4 showed an increase of male prevalence over a 3-year period (p < 0.001). In conclusion, subtype 1b and 2a/2c showed a very similar prevalence, age and gender distribution in Central Italy. The type 4 patient group was analyzed because an increase of this genotype (1.8 times) was detected.

Hepatitis C virus (HCV) exposure is due mainly to infected human blood. Most people with acute HCV infection are unable to clear the virus leading to chronic infection that may progress to cirrhosis and hepatocellular carcinoma. HCV genotyping is very useful to optimize the therapy because it helps to identify the patients that need a more aggressive management (e.g., type 1). The aim of this study was to detect the HCV genotype of 915 patients of Central Italy and to analyze the possible change in the prevalence of genotypes not common in Italy, such as type 4. We used a line-probe assay (INNO-LiPA HCV II, Innogenetics) based on reverse hybridization of HCV genome fragments previously amplified by a Polymerase Chain Reaction assay, COBAS System Amplicor HCV monitor version 2.0 (Roche Diagnostics Systems Inc.). HCV type 1 was detected in 448 cases (49.0%), type 2 in 318 cases (34.8%), type 3 in 109 cases (11.9%), type 4 in 33 cases (3.6%) and co-infections in 7 cases (0.7%). In particular, 339 cases (37.0%) showed subtype 1b, 302 cases (33.0%) 2a/2c, 108 cases (11.8%) 3a and 74 cases (8.1%) subtype 1a. The prevalence of type 4 was 3.3% from September 1999 to July 2002 and 4.5% from August 2002 to April 2003. We confirmed that HCV type 1 is prevalent in Central Italy, in particular subtype 1b, followed by type 2a/2c. We also described that the prevalence of type 4 seems to have increased whereas co-infection is a rare event.

Recently Storey et al. showed that p53 polymorphism at codon 72 was related to cervical cancer. This polymorphism encodes either arginine (p53Arg) or proline (p53Pro). p53Arg was found to be more susceptible than p53Pro to E6-mediated degradation. Many studies were performed but conclusions are controversial. In this paper, we report our results from 80 women of central Italy, 30 patients showing High-grade Cervical Intraepithelial Neoplasia or squamous cell carcinoma (SCC) and 50 healthy women of the same age. The polymorphism was examined using the Storey's procedure, a molecular method, from formalin-fixed, paraffin-embedded biopsies (patients) and from cytological oral-samples (controls). The distribution of the genotypes among the cases was 27% heterozygous, 27% p53Pro-homozygous and 46% p53Arg-homozygous, while among the controls it was 52%, 2% and 46%, respectively. There was not an increased risk of SCC associated with p53Arg-homozygous; indeed there is a tendency for the contrary (odds ratio, 0.06; 99.4% confidence interval, 0.006-0.63; p = 0.019). Considering: 1) the biological characteristics of p53Pro in vitro; 2) the DNA quality, from formalin-fixed tissue, of our patients; and 3) the small number of samples performed in our study, we can only confirm that p53Pro is not a risk factor in vivo for cervical carcinogenesis in central Italy.

The PAPNET System is the only device with a neural-network-based-artificial intelligence to detect and show the images of abnormal cells on the monitor to be evaluated in an interactive way. We effectively used the PAPNET in rescreening of conventional cervical smears and we detected its advantages and its disadvantages. In this paper, we report our results from PAPNET-assisted primary screening performed on 20,154 conventional smears. The smears were classified as Negative or as Review. The Negative cases were rapidly rescreened mainly near the coverslip edges, which are the slide areas not analyzed by automated devices because of focusing problems. The Review cases were fully reanalyzed by the optic microscope. In summary, 140 positive smears were detected: 57 cases showed changes due to HPV, 63 LSIL, 15 HSIL, and 5 carcinomas. Therefore, the PAPNET System was confirmed as useful in primary screening of conventional cervical samples as well as rescreening.

In this study, we evaluated (a) quantitative modifications of dust cells and siderocytes and (b) qualitative modifications (i.e., cellular changes and inflammatory infiltrate) in sputum of 164 traffic policemen occupationally exposed to environmental pollution in an urban area. Such modifications were correlated with time of exposure and smoking habits. Seventy-three (45%) of the policemen were smokers, and a control group of 119 nonexposed individuals (24% smokers) who resided in a rural district near Perugia, Italy, were examined. The sputa, which was collected for 3 d, were smeared on glass slides stained according to Papanicolaou's and Perl's methods. The mean numbers of dust cells in the sputa policemen and the rural population were 103.8 and 12.48, respectively (p < .0001). The numbers of dust cells were highest in policemen who smoked (relative risk = 3.95; p < .006). The mean numbers of siderocytes in policemen and the rural population were 0.99 and 5.31, respectively (not statistically significant, Mann-Whitney test). The difference between the number of subjects with hemosiderin-laden macrophages in traffic policemen and in the control group was small, but it was significant statistically (p < .004). In traffic policemen, it was related to smoking and time of exposure to air pollution, whereas in the control population it was related to heart-pulmonary diseases. In this study, we observed a synergistic effect between smoking and environmental pollution. In addition, less than 5 y of exposure can caused significantly increased (a) numbers of macrophages and (b) inflammatory infiltrate in sputa. The results of the cytological diagnosis revealed a statistically significant difference between policemen and the rural population (p < .001). The cytological exam of sputa and correlations with smoking within each population were not statistically significant. In conclusion, macrophage count in sputum is a sensitive and reproducible method for investigators to verify pulmonary changes that may be observed before they can be measured by functional tests.