Göktuğ Kadıoğlu Berrin, Çınar Tanrıverdi Esra, Alay Handan, Uçar Mahmut
University of Health Sciences, Regional Training and Research Hospital, Clinic of Obstetrics and Gynecology, Erzurum, Turkey.
Atatürk Üniversity Faculty of Medicine, Division of Medical Education, Erzurum, Turkey.
Mikrobiyol Bul. 2018 Oct;52(4):367-375. doi: 10.5578/mb.67419.
Cervical cancer is a common female cancer that could be diagnosed early with screening methods. Almost all cases are caused by human papilloma virus (HPV) infection. Therefore, detecting the presence of HPV DNA is important for early diagnosis and treatment. Regular determination of screening tests enables early detection of patients with the risk of cervical cancer. For this purpose, since August 2014 a new screening program has been carried out by Early Diagnosis, Screening and Training of Cancer Centers (KETEM). The aims of our study were to detect the HPV prevalence in Erzurum and determine the major HPV types under the scope of population based cervical cancer screening program. Female patients between the ages of 30-65 were included in the study. Pap-smear and HPV DNA samples were taken simultaneously. The samples were examined in a national central laboratory. The study was performed using conventional methods in pap-smear samples. Pap-smear samples from HPV (-) patients were not included in the pathological evaluation. Pathological results of the pap-smear samples, which were taken from the HPV (+) cases, were sent to KETEM by national central laboratory and then these results were used. Within the scope of this study, 52.000 women were screened. Among all these women 2.4% of the cases were HPV DNA positive. HPV DNA samples were screened by Hybrid capture 2 (Qiagen, Germany) method. The highest positivity was observed at age 40 with 65 cases (5.1%) and the lowest positivity was observed at age 65 with 2 cases (0.1%). 60.1% of the HPV positive cases were at 30-45 age group, 35.2% were at 45-60 age group and 4.6% were at 65 and above age group. The most common type was HPV 16 with the frequency of 12.2% and this was followed by HPV 31 with 7.4% and HPV 51 with 6.7%,HPV 52 with 4.4% and HPV 68 with 4.3% frequencies. The rate of the HPV 18, which is the type of HPV that carries high risk for causing cervical cancer, was 3.0%. 49.2% of the HPV positive cases had single and 50.8% of them contained more than one type of HPV. The most common pathological appearance was "low grade cervical intraepithelial lesion" (LGSIL) detected in 115 cases (9.2%) and "atypical squamous cells of unknown significance" (ASC-US) detected in 93 cases (7.4%). Cases that had abnormal cytology were referred to colposcopy. Consequently, it was concluded that regional screening is important in terms of the determination of the HPV type for the early diagnosis of cervical cancer and vaccination so prevalence studies should be increased and supported.
宫颈癌是一种常见的女性癌症，可通过筛查方法早期诊断。几乎所有病例都是由人乳头瘤病毒（HPV）感染引起的。因此，检测HPV DNA的存在对于早期诊断和治疗很重要。定期进行筛查测试能够早期发现有患宫颈癌风险的患者。为此，自2014年8月起，癌症中心早期诊断、筛查与培训部（KETEM）开展了一项新的筛查计划。我们研究的目的是在基于人群的宫颈癌筛查计划范围内，检测埃尔祖鲁姆地区的HPV流行情况并确定主要的HPV类型。年龄在30至65岁之间的女性患者被纳入研究。同时采集巴氏涂片和HPV DNA样本。样本在国家中央实验室进行检测。巴氏涂片样本采用传统方法进行检测。HPV（-）患者的巴氏涂片样本不纳入病理评估。从HPV（+）病例采集的巴氏涂片样本的病理结果由国家中央实验室发送至KETEM，然后使用这些结果。在本研究范围内，对52000名女性进行了筛查。在所有这些女性中，2.4%的病例HPV DNA呈阳性。HPV DNA样本采用杂交捕获2法（德国Qiagen公司）进行检测。在40岁时观察到最高阳性率，有65例（5.1%），在65岁时观察到最低阳性率，有2例（0.1%）。60.1%的HPV阳性病例在30至45岁年龄组，35.2%在45至60岁年龄组，4.6%在65岁及以上年龄组。最常见的类型是HPV 16，频率为12.2%，其次是HPV 31，频率为7.4%，HPV 51频率为6.7%，HPV 52频率为4.4%，HPV 68频率为4.3%。携带导致宫颈癌高风险的HPV类型18的比例为3.0%。49.2%的HPV阳性病例为单一类型，50.8%的病例包含不止一种HPV类型。最常见的病理表现是115例（9.2%）检测到的“低级别宫颈上皮内瘤变”（LGSIL）和93例（7.4%）检测到的“意义不明确的非典型鳞状细胞”（ASC-US）。细胞学异常的病例被转诊至阴道镜检查。因此，得出结论，就确定HPV类型以早期诊断宫颈癌和进行疫苗接种而言，区域筛查很重要，所以患病率研究应增加并得到支持。
