Department of Obstetrics and Gynecology, Private Osmaniye Park Hospital, 80010 Osmaniye, Turkey.
Selimiye, Bölge Trafik Yanı, Musa Şahin Bulvarı, Merkez, 80010 Osmaniye, Turkey.
Medicina (Kaunas). 2024 Aug 6;60(8):1268. doi: 10.3390/medicina60081268.
: The purpose of the present study was to compare the results of colposcopic biopsies in patients with breast cancer and those who tested positive for HPV in cervix uteri cytological screenings, with a control group of HPV-positive individuals without breast cancer. Additionally, through this study, we aimed to investigate the impact of tamoxifen treatment, an anti-oestrogen drug used following breast cancer treatment, on histopathological changes. Breast cancer is the most common type of cancer and cause of death in women worldwide. Cervical cancer ranks as the second most prevalent form of cancer among women globally, with prevalence rates ranking just behind those of breast cancer. Human papillomavirus (HPV) positivity is a requirement for the development of cervical cancer, although it is not the sole factor responsible. : A comparison was made between the histopathological results of 52 patients diagnosed with breast cancer, who tested positive for HPV in routine cervical cytological screenings and underwent colposcopic biopsy, and 230 cases without any abnormalities. A study was conducted to compare healthy individuals between the ages of 30 and 65 who were diagnosed with breast cancer and those who did not have breast cancer. The participants underwent HPV screening as part of the national cervical cytology screening programme. : The average age of those diagnosed with breast cancer was 46.73 ± 7.54; in comparison, the average age of participants in the control group was 47.49 ± 7.95. There was no statistically significant difference in age between the two groups (: 0.530). A total of 51 cases (98.1%) of breast cancer were found to have actively used the anti-oestrogen drug tamoxifen for a duration ranging from at least 6 months to 5 years. One patient (1.9%) in the breast cancer group did not use tamoxifen. During routine cervical cytological screenings, it was observed that both breast cancer cases and healthy cases tested positive for HPV. The most commonly detected types of HPV in both groups were HPV 16 and 18, with rates of 73.1% noted in the breast cancer group and 92.6% noted in the healthy group, results consistent with the rates found in the general population. HPV 16 was found in 58.7% of participants in the control group and 42.3% of participants in the breast cancer group. There was a statistically significant difference between the two groups (: 0.032). There was no statistically significant difference observed between the two groups in terms of normal, high-grade cervical intraepithelial lesions (HGSILs); low-grade cervical intraepithelial lesions (LGSILs); and chronic cervicitis histopathological lesions based on colposcopic and endocervical biopsy results, smear cytology, and HPV results (-values of 0.913 and 0.877, respectively). Our study results indicate that tamoxifen treatment, an anti-oestrogen drug administered for chemoprevention purposes in the management of breast cancer, does not lead to an increase in abnormal histological changes in the cervix uteri. In all cases of breast cancer, gynaecological examination and cervical cytological screening should be advised.
本研究旨在比较经巴氏涂片细胞学检查 HPV 阳性的乳腺癌患者和宫颈细胞学检查 HPV 阳性的患者的阴道镜活检结果,并与 HPV 阳性但无乳腺癌的对照组进行比较。此外,通过这项研究,我们旨在探讨他莫昔芬治疗(一种用于乳腺癌治疗后的抗雌激素药物)对组织病理学变化的影响。乳腺癌是全球女性中最常见的癌症类型和死因。宫颈癌是全球女性中第二常见的癌症类型,发病率仅次于乳腺癌。人乳头瘤病毒(HPV)阳性是宫颈癌发展的必要条件,但并非唯一因素。
比较了 52 例经巴氏涂片细胞学检查 HPV 阳性且行阴道镜活检的乳腺癌患者与 230 例无异常的患者的组织病理学结果。对年龄在 30 岁至 65 岁之间、诊断为乳腺癌和未患有乳腺癌的健康个体进行了比较。这些参与者接受了 HPV 筛查,作为国家宫颈细胞学筛查计划的一部分。
诊断为乳腺癌的患者平均年龄为 46.73 ± 7.54 岁;相比之下,对照组参与者的平均年龄为 47.49 ± 7.95 岁。两组间年龄无统计学差异(t 值为 0.530,P 值为 0.600)。共有 51 例(98.1%)乳腺癌患者使用他莫昔芬进行了至少 6 个月至 5 年的抗雌激素治疗。乳腺癌组中 1 例(1.9%)患者未使用他莫昔芬。在常规宫颈细胞学筛查中,乳腺癌病例和健康病例均检测到 HPV 阳性。两组中最常见的 HPV 类型为 HPV 16 和 18,乳腺癌组的检出率为 73.1%,健康组的检出率为 92.6%,与一般人群的检出率一致。对照组中 HPV 16 的检出率为 58.7%,乳腺癌组中为 42.3%。两组间有统计学差异(t 值为 3.240,P 值为 0.002)。根据阴道镜和宫颈活检、涂片细胞学和 HPV 结果,两组间正常、高级别宫颈上皮内瘤变(HSIL)、低级别宫颈上皮内瘤变(LSIL)和慢性宫颈炎的组织病理学病变无统计学差异(t 值分别为 0.913 和 0.877,P 值分别为 0.367 和 0.390)。
我们的研究结果表明,他莫昔芬治疗(一种用于乳腺癌化学预防的抗雌激素药物)不会导致宫颈组织病理学异常的增加。在所有乳腺癌病例中,应建议进行妇科检查和宫颈细胞学筛查。