The application of human papilloma virus genotyping for the identification of neoplasm lesions in the cervix of women with abnormal cytology smears.

BACKGROUND

A connection between infections with a highly oncogenic type of human papilloma virus and the development of cervical intraepithelial neoplasia and preinvasive cervical cancer has been proven both experimentally and clinically. The period after which persistent virus infection will lead to the development of precancerous and invasive lesions is dependent on, among others, the HPV genotype. The oncogenic types of human papilloma virus destabilize the genome of an infected cell and thus initiate the carcinogenesis process.

OBJECTIVES

The aim of this work was to analyze the frequency of occurrence of different oncogenic HPV genotypes among women with abnormal cytological smears and the correlation of this data with the degree of cervical intraepithelial neoplasia exacerbation.

MATERIAL AND METHODS

The sample consisted of 75 women of child-bearing age (16-43 years old) with an abnormal cytological smear and positive test identifying an infection with an oncogenic type of human papilloma virus. In every case histopathological verification, aimed at excluding pathologies in the endocervix, was conducted using a colposcopy with guided biopsy and cervix abrasion.

RESULTS

The authors found that the frequency of occurrence of different HPV genotypes of the groups of cytological diagnoses ASC-US, LSIL and HSIL do not differ statistically (p = 0.57). However, what is noteworthy is the more common occurrence of HPV 16 in type LSIL lesions (45.45%) and HPV 18 of a more advanced type HSIL (37.50%) pathology. Through the verification of the cytology results with histopathological diagnosis of the above groups the authors obtained statistically significant differences (p < 0.001) of individual pathological states. When regarding cytological HSIL diagnosis, CIN 1 was never diagnosed, while in other cytological groups cervical intraepithelial neoplasia of a low degree constituted over 40%. Analogically about 40% of HSIL diagnoses after histopathological verification turned out to be cancer of a pre-invasive state (CIS/AIS), the presence of which was not revealed by ASC-US and LSIL. What is more, CIN2/3 diagnosis was less frequent in the ASC-US cytological group than in the other two groups. While analyzing a share of other than HPV 16 and HPV 18 oncogenic types of human papilloma virus, the authors found that the most common were HPV 31, 45 and 33. In CIN 1 and CIN 2 their share was over 60%. In CIS/AIS type pathologies, no other types of human papilloma virus than HPV 16 and HPV 18 were shown.

CONCLUSIONS

Positive results of DNA HR HPV testing of women with abnormal cytology results identified a risk group for the development of cervical cancer. No statistically significant differences of the frequency of HPV 16 and HPV 18 type occurrences were found in analyzed groups with cytological and histopathological diagnoses.