Evaluation of Human Papilloma Virus (HPV) Existance with Molecular Methods in Sexually Active Women

Yıl 2019, Cilt: 7 Sayı: 2, 217 - 221, 25.05.2019

Mustafa Yöntem Abdullah Gümüş Remzi Abalı Meltem Öznur Fatih Erci Behiç Selman Erdoğdu

https://doi.org/10.21541/apjes.513783

Cited By: 1

Öz

The aim of this study was to determine HPV DNA by PCR in smear and biopsy materials in patients with abnormal smear and
to compare the results with biopsy. The study included 24 patients aged 26 to 74 years. Patients with H-SIL, L-SIL or ASCUS who were diagnosed with abnormal smear during the pathological evaluation were evaluated and the presence of HPV was
investigated with molecular tests. Demographic information was obtained from patients before colposcopy and the presence of
factors that may cause HPV infection were examined. In pathological specimens taken from patients with abnormal smear results,
biopsy was diagnosed as cervical CA in 33%, H-SIL in 4%, L-SIL in 13%, and normal in 50% of patients. HPV DNA was
determined, and it was observed that HPV 16 was the highest prevalence of HPV subtypes (HPV 16, HPV 18, HPV 31 and HPV
58). Of the 5 patients with HPV 16, 4 were found to have cervical CA, while the remaining 1 was H-SIL. In addition, the HPV
positivity rate was higher in people with more than 1 partner, whereas the number of HPV positive cases was three or more in
gravity. In this study; the contribution of pathological diagnostic methods and microbiological results to the diagnosis, and the
importance of the scanning programs and early diagnosis was revealed.

Anahtar Kelimeler

Cervical cancer, cervical intraepithelial neoplasia, HPV, smear

Human Papilloma Virüs (HPV) Varlığının Cinsel Aktif Kadınlarda Moleküler Metodlarla Değerlendirilmesi

Öz

Bu çalışmada, anormal
smear tanısı konan hastalarda, smear ve biyopsi materyallerinde PCR yöntemi ile HPV DNA
analizi yapılarak sonuçların biyopsi tanısıyla karşılaştırılması amaçlanmıştır.
Çalışma, yaşları 26 ile 74 arasında değişen 24 hasta üzerinde
gerçekleştirilmiştir. Ele alınan vakalardan patolojik değerlendirme sonucunda
H-SIL, L-SIL veya ASCUS ile anormal smear tanısı konmuş hastalara kolposkopik
biyopsi yapılarak örnekler elde edilmiş ve moleküler testler ile HPV varlığı
araştırılmıştır. Kolposkopi öncesinde hastalara anket uygulanarak demografik
bilgiler elde edilmiş ve HPV enfeksiyonuna neden olabilecek faktörlerin varlığı
incelenmiştir. Anormal smear sonucuna sahip hastalardan alınan patolojik
örneklerde, biyopsi tanısı %33’ünde serviks CA, %4’ünde H-SIL, %13’ünde L-SIL
ve %50’si normal olarak bulunmuştur. Ayrıca, normal smear sonucuna sahip tüm
hastaların %33’ünde HPV DNA belirlenmiş ve belirlenen HPV alt tipleri (HPV 16,
HPV 18, HPV 31 ve HPV 58) arasında en yüksek oranda izlenen alt tipin HPV 16
olduğu tespit edilmiştir. HPV 16 bulunan 5 hastadan 4’ünün biyopsi tanısının
serviks CA olduğu tespit edilmiş, kalan 1 hastanın ise H-SIL olduğu
görülmüştür. Ayrıca, partner sayısı 1’den fazla olan kişilerde HPV pozitiflik
oranının yüksek olduğu görülürken, HPV pozitif vakaların tamamının gravide
sayısının üç veya üzeri olduğu gözlenmiştir. Bu çalışmada patolojik tanı
yöntemleri ve mikrobiyolojik inceleme sonuçlarının tanıya katkısı ortaya
konulmuş, tarama programlarının ve erken teşhisin önemi bir kez daha ortaya
çıkarılmıştır.

Anahtar Kelimeler

HPV, servikal intraepitelyal neoplazi, serviks kanseri, smear

Kaynakça

• [1] W.-J. Koh et al., "Cervical cancer, version 2.2015," Journal of the National Comprehensive Cancer Network, vol. 13, no. 4, pp. 395-404, 2015.
• [2] J. Ferlay et al., "Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012," International journal of cancer, vol. 136, no. 5, pp. E359-E386, 2015.
• [3] M. Schiffman, N. Wentzensen, S. Wacholder, W. Kinney, J. C. Gage, and P. E. Castle, "Human papillomavirus testing in the prevention of cervical cancer," Journal of the National cancer institute, vol. 103, no. 5, pp. 368-383, 2011.
• [4] S. K. Kjær, K. Frederiksen, C. Munk, and T. Iftner, "Long-term absolute risk of cervical intraepithelial neoplasia grade 3 or worse following human papillomavirus infection: role of persistence," Journal of the National Cancer Institute, vol. 102, no. 19, pp. 1478-1488, 2010.
• [5] E.-M. De Villiers, C. Fauquet, T. R. Broker, H.-U. Bernard, and H. zur Hausen, "Classification of papillomaviruses," Virology, vol. 324, no. 1, pp. 17-27, 2004.
• [6] E. J. Crosbie, M. H. Einstein, S. Franceschi, and H. C. Kitchener, "Human papillomavirus and cervical cancer," The Lancet, vol. 382, no. 9895, pp. 889-899, 2013.
• [7] S. De Sanjosé et al., "Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis," The Lancet infectious diseases, vol. 7, no. 7, pp. 453-459, 2007.
• [8] K. Münger and P. M. Howley, "Human papillomavirus immortalization and transformation functions," Virus research, vol. 89, no. 2, pp. 213-228, 2002.
• [9] A. K. Chaturvedi, "Beyond cervical cancer: burden of other HPV-related cancers among men and women," Journal of Adolescent Health, vol. 46, no. 4, pp. S20-S26, 2010.
• [10] M. L. Gillison, A. K. Chaturvedi, and D. R. Lowy, "HPV prophylactic vaccines and the potential prevention of noncervical cancers in both men and women," Cancer, vol. 113, no. S10, pp. 3036-3046, 2008.
• [11] E. M. Burd, "Human papillomavirus and cervical cancer," Clinical microbiology reviews, vol. 16, no. 1, pp. 1-17, 2003.
• [12] N. Munoz, X. Castellsagué, A. B. de González, and L. Gissmann, "HPV in the etiology of human cancer," Vaccine, vol. 24, pp. S1-S10, 2006.
• [13] E. F. Dunne et al., "Prevalence of HPV infection among females in the United States," Jama, vol. 297, no. 8, pp. 813-819, 2007.
• [14] M. Arbyn and J. Dillner, "Review of current knowledge on HPV vaccination: an appendix to the European Guidelines for Quality Assurance in Cervical Cancer Screening," Journal of Clinical Virology, vol. 38, no. 3, pp. 189-197, 2007.
• [15] C. G. A. R. Network, "Integrated genomic and molecular characterization of cervical cancer," Nature, vol. 543, no. 7645, p. 378, 2017.
• [16] A. Ağaçfidan, "Cinsel yolla bulaĢan hastalıklarda laboratuvarda tanı olanakları," ANKEM Dergisi, vol. 26, pp. 189-197, 2012.
• [17] F. Sahiner, "Current problems and recent advances in the molecular diagnosis of genital human papillomavirus infections," Mikrobiyol Bul, vol. 48, no. 4, pp. 689-706, 2014.
• [18] M. Schiffman, P. E. Castle, J. Jeronimo, A. C. Rodriguez, and S. Wacholder, "Human papillomavirus and cervical cancer," The Lancet, vol. 370, no. 9590, pp. 890-907, 2007.
• [19] C. B. Woodman et al., "Natural history of cervical human papillomavirus infection in young women: a longitudinal cohort study," The Lancet, vol. 357, no. 9271, pp. 1831-1836, 2001.
• [20] L. Kjellberg et al., "Smoking, diet, pregnancy and oral contraceptive use as risk factors for cervical intra-epithelial neoplasia in relation to human papillomavirus infection," British journal of cancer, vol. 82, no. 7, p. 1332, 2000.
• [21] H. Yetimalar, A. Köksal, M. İnceoğlu, and B. Kasap, "Premalign ve malign servikal lezyonlu hastalarda HPV enfeksiyonu," Türk Jinekoloji ve Obstetrik Derneği Dergisi, vol. 6, no. 4, p. 273, 2009.
• [22] N. Muñoz et al., "Epidemiologic classification of human papillomavirus types associated with cervical cancer," New England Journal of Medicine, vol. 348, no. 6, pp. 518-527, 2003.
• [23] L. E. Manhart et al., "Human papillomavirus infection among sexually active young women in the United States: implications for developing a vaccination strategy," Sexually transmitted diseases, vol. 33, no. 8, pp. 502-508, 2006.
• [24] E. Mazarico, R. Gómez, L. Guirado, N. Lorente, and E. Gonzalez-Bosquet, "Relationship between smoking, HPV infection, and risk of cervical cancer," Eur. J. Gynaec. Oncol.-ISSN, vol. 392, p. 2936, 2015.
• [25] R. C. Eldridge et al., "Smoking and subsequent human papillomavirus infection: A mediation analysis," Annals of epidemiology, vol. 27, no. 11, pp. 724-730. e1, 2017.