Beyazit Fatma, Sılan Fatma, Gencer Meryem, Aydin Buket, Paksoy Barış, Unsal Mesut A, Ozdemir Ozturk
Canakkale 18 Mart University, 17100 Canakkale, Turkey.
Ginekol Pol. 2018;89(2):62-67. doi: 10.5603/GP.a2018.0011.
Cervical cancer is the second most common type of cancer for women worldwide with a great proportion proved to be related to human papillomavirus (HPV) infection. As infection with HPV is the strongest risk factor for cervical neoplasia, detection of HPV genotypes in cervical and vaginal specimens of women with normal and abnormal cytology seems to be of paramount importance in cervical cancer screening. The objective of the study is to evaluate the prevalence and HPV genotypes among women with normal or abnormal Pap smear tests.
This retrospective study was conducted in a tertiary care university hospital in western Turkey. A total of 201 patients in whom both HPV typing and Pap test was performed between 2012 and 2016 in our obstetrics and gynecology department were enrolled in this study. Clinical and laboratory data were obtained for all participants. Cervical smears of the patients were classified by the Bethesda system and HPV analyses were done using the polymerase chain reaction (PCR) method.
This study included 201 women, 72 of whom had normal and 129 of whom had abnormal Pap smear results. HPV DNA was detected in 91 (45.2%) of the 201 investigated women. Out of 72 patients with normal cervico-vaginal cytology, HPV positivity was detected in 35 (49%) patients, whereas 33 (35%) patients out of 94 with ASCUS , 18 (62%) patients out of 29 with LSIL and 5 (83%) patients out of 6 with HSIL had HPV positivity. Out of 35 HPV positive women that had normal pap test results, 25 (75%) were found to have high risk HPV (HR-HPV) genotypes. In women with ASCUS, LSIL and HSIL, HR-HPV genotype rates were found to be 94%, 89% and 100% respectively. The most common identified HPV types were HPV58, HPV16, HPV31, HPV33, HPV11 and HPV35.
The frequency of HPV infection was found to be higher in our study compared to previous reports. Moreover, although HR-HPV genotypes were also detected in patients with normal cervical cytology, a majority of patients with HR-HPV genotypes were associated with abnormal cervical smear cytology including high rates of atypical squamous cells of undetermined significance, low-grade squamous intraepithelial lesion, and high-grade squamous intraepithelial lesion.
宫颈癌是全球女性中第二常见的癌症类型,很大一部分被证明与人类乳头瘤病毒(HPV)感染有关。由于HPV感染是宫颈肿瘤形成的最强风险因素,在细胞学正常和异常的女性宫颈及阴道标本中检测HPV基因型在宫颈癌筛查中似乎至关重要。本研究的目的是评估巴氏涂片检查结果正常或异常的女性中HPV的流行情况及基因型。
这项回顾性研究在土耳其西部的一家三级护理大学医院进行。共有201例在2012年至2016年间在我们妇产科同时进行了HPV分型和巴氏试验的患者纳入本研究。获取了所有参与者的临床和实验室数据。患者的宫颈涂片按照贝塞斯达系统进行分类,HPV分析采用聚合酶链反应(PCR)方法。
本研究纳入201名女性,其中72例巴氏涂片结果正常,129例巴氏涂片结果异常。在201名接受调查的女性中,有91例(45.2%)检测到HPV DNA。在72例宫颈阴道细胞学正常的患者中,35例(49%)检测到HPV阳性,而在94例非典型鳞状细胞意义不明确(ASCUS)患者中有33例(35%)、29例低度鳞状上皮内病变(LSIL)患者中有18例(62%)、6例高度鳞状上皮内病变(HSIL)患者中有5例(83%)检测到HPV阳性。在巴氏试验结果正常的35例HPV阳性女性中,有25例(75%)被发现携带高危型HPV(HR-HPV)基因型。在ASCUS、LSIL和HSIL女性中,HR-HPV基因型率分别为94%、89%和100%。最常见的HPV类型为HPV58、HPV16、HPV31、HPV33、HPV11和HPV35。
与之前的报告相比,我们的研究发现HPV感染频率更高。此外,虽然在宫颈细胞学正常的患者中也检测到了HR-HPV基因型,但大多数携带HR-HPV基因型的患者与宫颈涂片细胞学异常有关,包括非典型鳞状细胞意义不明确、低度鳞状上皮内病变和高度鳞状上皮内病变的高发生率。