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KONYA ŞEHİR HASTANESİ PATOLOJİ LABORATUVARINDA İNCELENEN SERVİKAL SİTOLOJİ ÖRNEKLERİNDEKİ YÜKSEK RİSKLİ HPV’LERİN GENOTİP DAĞILIMI VE EPİTELYAL HÜCRE ANOMALİLERİ İLE İLİŞKİSİ

Year 2023, Volume: 4 Issue: Kongre Özel, 18 - 30, 18.09.2023

Abstract

Giriş: Serviks kanseri, kadınlarda en sık görülen kanserlerden biridir. Yüksek riskli insan papilloma virüsü (yrHPV) ile kalıcı enfeksiyon, serviks kanseri için ana etiyolojik faktördür. Servikal sitoloji ve HPV DNA genotiplendirmesi, servikal neoplaziler için tarama testi olarak kullanılmaktadır. Bu çalışmada, Konya ilindeki, servikal sitoloji örneği alınmış ve eş zamanlı HPV DNA genotip analizi yapılmış olguların intraepitelyal lezyon ve malignite (ILM) oranını ve yüksek riskli HPV DNA genotip dağılımını saptamak amaçlanmıştır.
Materyal ve metot: Çalışmaya ocak 2021-aralık 2021 tarihleri arasında Konya Şehir hastanesi Tıbbi Patoloji Bölümü’nde servikal sitoloji ve eş zamanlı HPV DNA genotip analizi yapılan 3885 olgudan yrHPV DNA sonucu pozitif olan 145 olgu dahil edildi. Olguların verilerine patoloji arşivinden ulaşıldı. Papanicolaou boyası(PAP) ile boyanmış sıvı bazlı sitoloji materyalleri, tekrar değerlendirilmeye alındı, Bethesda sınıflamasına göre sınıflandırıldı.
Bulgular: 3885 olgunun %3,7’sinde yrHPV pozitifliği saptandı. Hastaların yaş ortalaması 41.9±9.7 dir. Hastalarda en çok görülen HPV tipi, diğer yrHPV DNA (genotip 31,33,35,39,45,51,52,5 6,58,59,66,68) olarak belirlenmiştir (60%). Yine HPV pozitif olguların çoğunda (52.4%) sitolojik tanı ILM açısından negatiftir. HPV pozitif olgularda sitolojik tanılar arasında ise en sık gözlenen lezyon önemi belirlenemeyen atipik skuamöz hücreler(ASCUS)’dir (%49,3). HPV tiplerine göre sitolojik tanı dağılımları değerlendirildiğinde HPV tiplerine göre intraepitelyal lezyon gözlenen ve gözlenmeyen hastaların dağılımı, HPV tiplerine göre negatif sitopatolojik tanılar dahil tüm tanıların dağılımı ve HPV tiplerine göre sadece pozitif sitopatolojik tanıların dağılımları istatistiksel açıdan anlamlı farklılık göstermemiştir.
Tartışma ve Sonuç: Türkiye'de yapılan çalışmalarda yrHPV prevalansı %2-6’dır. Konya bölgesinde yaklaşık 5 yıl önce yapılan bir çalışmada yrHPV prevalansı %3,16 olarak bulunmuştur. Bizim sonuçlarımıza göre oranda hafif bir artış mevcuttur. Bizim çalışmamızda, literatürün aksine, en yaygın tip, HPV16 değil, diğer yrHPV DNA (genotip 31,33,35,39,45,51,52,5 6,58,59,66,68) tipleridir. HPV prevalansı ve genotipler ülkeler arasında ve hatta aynı ülkenin farklı bölgelerinde farklılıklar göstermektedir. HPV enfeksiyonunun doğru prevalansını değerlendirmek için ülkemizin farklı bölgelerinde daha geniş epidemiyolojik çalışmalara ihtiyaç vardır.

References

  • Alacam, S., & Bakir, A. (2021). Human Papillomavirus Prevalence and Genotype Distribution in Cervical Swab Samples in Istanbul, Turkey. The Journal of Infection in Developing Countries, 15(08), 1190-1196.
  • Alotaibi, H. J., Almajhdi, F. N., Alsaleh, A. N., Obeid, D. A., Khayat, H. H., Al-Muammer, T. A., Tulbah, A.M., Alfageeh, M.B., Al-Ahdal, M.N., Alhamlan, F. S. (2020). Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia. Saudi Journal of Biological Sciences, 27(6), 1587-1595.
  • Aslan, F. G., Us, T., Kaşifoğlu, N., Özalp, S. S., Akgün, Y., Öge, T. (2016). Eskişehir’de Kadınlarda İnsan Papillomavirus Prevalansının, Pap Yayması, Hibrid Yakalama 2 Testi ve Konsensus Gerçek Zamanlı Polimeraz Zincir Reaksiyonu ile Araştırılması ve Pirodizileme Yöntemiyle Tiplendirilmesi. Mikrobiyol Bul, 50(1), 73-85.
  • Aydoğmuş, H., Aydoğmuş, S. (2019). Comparison of colposcopic biopsy results of patients who have cytomorphological normal but HPV 16-18 or other high-risk HPV subtypes positive. Asian Pacific Journal of Cancer Prevention: APJCP, 20(2), 417.
  • Beyazit, F., Sılan, F., Gencer, M., Aydin, B., Paksoy, B., Unsal, M. A., Ozdemir, O. (2018). The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology. Ginekologia polska, 89(2), 62-67.
  • Bruni, L., Diaz, M., Castellsagué, M., Ferrer, E., Bosch, F. X., de Sanjosé, S. (2010). Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. Journal of Infectious Diseases, 202(12), 1789-1799.
  • Bosch, F. X., Burchell, A. N., Schiffman, M., Giuliano, A. R., de Sanjose, S., Bruni, L., Luna, G.T., Kjaer, S.K., Munoz, N. (2008). Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine, 26, K1-K16.
  • Dursun, P., Ayhan, A., Mutlu, L., Çağlar, M., Haberal, A., Güngör, T., ... & Kirdar, S. (2013). HPV types in Turkey: Multicenter hospital based evaluation of 6388 patients in Turkish gynecologic oncology group centers Türkiye'Deki HPV tipleri: Türk jinekolojik onkoloji grubuna üye merkezlere başvuran 6388 hastanin retrospektif analizi. Turk Patoloji Dergisi/Turkish Journal of Pathology, 29(3), 210-216.
  • Findik, S., Findik, S., Abuoğlu, S., Cihan, F. G., Ilter, H., & Iyisoy, M. S. (2019). Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey. International Journal of Clinical and Experimental Pathology, 12(4), 1391-1398.
  • Ghosh, T., VandeHaar, M. A., Rivera, M., Henry, M. R. (2018). High-risk HPV genotype distribution in HPV co-test specimens: study of a predominantly Midwestern population. Journal of the American Society of Cytopathology, 7(2), 99-105.
  • Giray, B., Kabaca, C., Uzun, M. G., Akis, S., Purut, Y. E., Peker, E. K., Cetiner, H. (2021). Is cervical cytology testing as a part of co‐test unnecessary for HPV 16/18‐infected women? A retrospective cohort study of 1647 women. Diagnostic Cytopathology, 49(2), 267-272.
  • Göktuğ Kadıoğlu, B., Çınar Tanrıverdi, E., Alay, H., & Uçar, M. (2018). Erzurum İlinde 52.000 Kadında Hybrid Capture 2 Yöntemi Kullanılarak Yapılan İnsan Papilloma virüs (HPV) Tarama Sonuçlarının Serviks Kanseri ile İlişkisi. Mikrobiyoloji Bülteni, 52(4), 367-375.
  • Kussaibi, H., Al Dossary, R., Ahmed, A., Muammar, A., Aljohani, R. (2021). Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia. Acta Cytologica, 65(1), 48-55.
  • Mbulawa, Z. Z., Coetzee, D., Williamson, A. L. (2015). Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status. BMC infectious diseases, 15(1), 1-11.
  • Rahmat, F., Kuan, J. Y., Hajiman, Z., Shakrin, N. N. S. M., Roos, N. A. C., Mustapa, M., Ahmad Zaidi, N.A., Ahmad, A. (2021). Human Papillomavirus (HPV) Prevalence and Type Distribution in Urban Areas of Malaysia. Asian Pacific journal of cancer prevention: APJCP, 22(9), 2969-2975.
  • Seneldir, H., Kir, G. (2019). Prevalence of high‐risk human papilloma virus in liquid‐based cervical samples from Turkish women with normal and abnormal cytology. Diagnostic Cytopathology, 47(2), 100-104.
  • Sharifa Ezat, W.P., Sharifah, N.A., Sayyidi Hamzi A.R., Norin R.S., Shamsul, A.S., Syed, M.A. (2010). Prevalence of human papillomavirus genotypes in preinvasive and invasive cervical cancer-a UKM study. Medicine and Health, 66-76.
  • Siegler, E., Shiner, M., Segev, Y., Mackuli, L., Lahat, N., Lavie, O. (2017). Prevalence and Genotype Distribution of HPV Types in Women at Risk for Cervical Neoplasia in Israel. The Israel Medical Association journal: IMAJ, 19(10), 635-639.
  • Yavuzer, D., Karadayı, N., Erdağı, A., Salepçi, T., Baloğlu, H., Dabak, R. (2009). Serviks kanseri ve prekanseröz lezyonlarında PCR ile HPV tiplemesi. Kartal Eğitim Ve Araştırma Hastanesi Tıp Dergisi, XX(1):1-6.

Genotype distribution of high-risk HPVs in cervical cytology samples examined in the pathology laboratory of Konya City Hospital and its relationship with epithelial cell anomalies

Year 2023, Volume: 4 Issue: Kongre Özel, 18 - 30, 18.09.2023

Abstract

Introduction: Cervical cancer is one of the most common cancers in women. Persistent infection with high-risk human papillomavirus (hrHPV) is the main etiologic factor for cervical cancer. Cervical cytology and HPV DNA genotyping are used as screening tests for cervical neoplasms. In this study, it was aimed to determine the intraepithelial lesion and malignancy (ILM) rate and high-risk HPV DNA genotype distribution of cases in Konya province, whose cervical cytology samples were taken and HPV DNA genotype analysis was performed simultaneously.
Material and method: The study included 145 cases with positive hrHPV DNA results out of 3885 cases who underwent cervical cytology and simultaneous HPV DNA genotype analysis in Konya City Hospital Medical Pathology Department between January 2021 and December 2021. The data of the cases were obtained from the pathology archive. Liquid-based cytology materials stained with Papanicolaou stain (PAP) were re-evaluated and classified according to the Bethesda classification.
Results: hrHPV positivity was detected in 3.7% of 3885 cases. The mean age of the patients was 41.9±9.7. The most common HPV type in patients was determined as other hrHPV DNA (genotype 31,33,35,39,45,51,52.5 6,58,59,66,68) (60%). Again, in most of the HPV-positive cases (52.4%), the cytological diagnosis is negative for ILM. Among the cytological diagnoses in HPV-positive cases, the most frequently observed lesion is atypical squamous cells of undetermined significance (ASCUS) (49.3%). When cytological diagnosis distributions were evaluated according to HPV types, there was no statistically significant difference between patients with and without intraepithelial lesions according to HPV types. The distribution of ILM-positive cytopathological diagnoses by HPV types did not differ statistically significantly. The distribution of all diagnoses, including ILM-negative cytopathological diagnoses, according to HPV types did not show a statistically significant difference.
Conclusion: In studies conducted in Turkey, the prevalence of HPV is 2-6%. In a study conducted in the Konya region about 5 years ago, the prevalence of HPV was found to be 3.16%. According to our results, there is a slight increase in the rate. In our study, contrary to the literature, the most common type was not HPV16, but other types of hrHPV DNA (genotype 31,33,35,39,45,51,52,5 6,58,59,66,68).HPV prevalence and genotypes countries vary between countries and even in different regions of the same country. Larger epidemiological studies are needed in different regions of our country to accurately assess the prevalence of HPV infection.

References

  • Alacam, S., & Bakir, A. (2021). Human Papillomavirus Prevalence and Genotype Distribution in Cervical Swab Samples in Istanbul, Turkey. The Journal of Infection in Developing Countries, 15(08), 1190-1196.
  • Alotaibi, H. J., Almajhdi, F. N., Alsaleh, A. N., Obeid, D. A., Khayat, H. H., Al-Muammer, T. A., Tulbah, A.M., Alfageeh, M.B., Al-Ahdal, M.N., Alhamlan, F. S. (2020). Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia. Saudi Journal of Biological Sciences, 27(6), 1587-1595.
  • Aslan, F. G., Us, T., Kaşifoğlu, N., Özalp, S. S., Akgün, Y., Öge, T. (2016). Eskişehir’de Kadınlarda İnsan Papillomavirus Prevalansının, Pap Yayması, Hibrid Yakalama 2 Testi ve Konsensus Gerçek Zamanlı Polimeraz Zincir Reaksiyonu ile Araştırılması ve Pirodizileme Yöntemiyle Tiplendirilmesi. Mikrobiyol Bul, 50(1), 73-85.
  • Aydoğmuş, H., Aydoğmuş, S. (2019). Comparison of colposcopic biopsy results of patients who have cytomorphological normal but HPV 16-18 or other high-risk HPV subtypes positive. Asian Pacific Journal of Cancer Prevention: APJCP, 20(2), 417.
  • Beyazit, F., Sılan, F., Gencer, M., Aydin, B., Paksoy, B., Unsal, M. A., Ozdemir, O. (2018). The prevelance of human papillomavirus (HPV) genotypes detected by PCR in women with normal and abnormal cervico-vaginal cytology. Ginekologia polska, 89(2), 62-67.
  • Bruni, L., Diaz, M., Castellsagué, M., Ferrer, E., Bosch, F. X., de Sanjosé, S. (2010). Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings. Journal of Infectious Diseases, 202(12), 1789-1799.
  • Bosch, F. X., Burchell, A. N., Schiffman, M., Giuliano, A. R., de Sanjose, S., Bruni, L., Luna, G.T., Kjaer, S.K., Munoz, N. (2008). Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine, 26, K1-K16.
  • Dursun, P., Ayhan, A., Mutlu, L., Çağlar, M., Haberal, A., Güngör, T., ... & Kirdar, S. (2013). HPV types in Turkey: Multicenter hospital based evaluation of 6388 patients in Turkish gynecologic oncology group centers Türkiye'Deki HPV tipleri: Türk jinekolojik onkoloji grubuna üye merkezlere başvuran 6388 hastanin retrospektif analizi. Turk Patoloji Dergisi/Turkish Journal of Pathology, 29(3), 210-216.
  • Findik, S., Findik, S., Abuoğlu, S., Cihan, F. G., Ilter, H., & Iyisoy, M. S. (2019). Human papillomavirus (HPV) subtypes and their relationships with cervical smear results in cervical cancer screening: a community-based study from the central Anatolia region of Turkey. International Journal of Clinical and Experimental Pathology, 12(4), 1391-1398.
  • Ghosh, T., VandeHaar, M. A., Rivera, M., Henry, M. R. (2018). High-risk HPV genotype distribution in HPV co-test specimens: study of a predominantly Midwestern population. Journal of the American Society of Cytopathology, 7(2), 99-105.
  • Giray, B., Kabaca, C., Uzun, M. G., Akis, S., Purut, Y. E., Peker, E. K., Cetiner, H. (2021). Is cervical cytology testing as a part of co‐test unnecessary for HPV 16/18‐infected women? A retrospective cohort study of 1647 women. Diagnostic Cytopathology, 49(2), 267-272.
  • Göktuğ Kadıoğlu, B., Çınar Tanrıverdi, E., Alay, H., & Uçar, M. (2018). Erzurum İlinde 52.000 Kadında Hybrid Capture 2 Yöntemi Kullanılarak Yapılan İnsan Papilloma virüs (HPV) Tarama Sonuçlarının Serviks Kanseri ile İlişkisi. Mikrobiyoloji Bülteni, 52(4), 367-375.
  • Kussaibi, H., Al Dossary, R., Ahmed, A., Muammar, A., Aljohani, R. (2021). Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia. Acta Cytologica, 65(1), 48-55.
  • Mbulawa, Z. Z., Coetzee, D., Williamson, A. L. (2015). Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status. BMC infectious diseases, 15(1), 1-11.
  • Rahmat, F., Kuan, J. Y., Hajiman, Z., Shakrin, N. N. S. M., Roos, N. A. C., Mustapa, M., Ahmad Zaidi, N.A., Ahmad, A. (2021). Human Papillomavirus (HPV) Prevalence and Type Distribution in Urban Areas of Malaysia. Asian Pacific journal of cancer prevention: APJCP, 22(9), 2969-2975.
  • Seneldir, H., Kir, G. (2019). Prevalence of high‐risk human papilloma virus in liquid‐based cervical samples from Turkish women with normal and abnormal cytology. Diagnostic Cytopathology, 47(2), 100-104.
  • Sharifa Ezat, W.P., Sharifah, N.A., Sayyidi Hamzi A.R., Norin R.S., Shamsul, A.S., Syed, M.A. (2010). Prevalence of human papillomavirus genotypes in preinvasive and invasive cervical cancer-a UKM study. Medicine and Health, 66-76.
  • Siegler, E., Shiner, M., Segev, Y., Mackuli, L., Lahat, N., Lavie, O. (2017). Prevalence and Genotype Distribution of HPV Types in Women at Risk for Cervical Neoplasia in Israel. The Israel Medical Association journal: IMAJ, 19(10), 635-639.
  • Yavuzer, D., Karadayı, N., Erdağı, A., Salepçi, T., Baloğlu, H., Dabak, R. (2009). Serviks kanseri ve prekanseröz lezyonlarında PCR ile HPV tiplemesi. Kartal Eğitim Ve Araştırma Hastanesi Tıp Dergisi, XX(1):1-6.
There are 19 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Research Articles
Authors

İlknur Küçükosmanoğlu 0000-0002-5181-6152

Publication Date September 18, 2023
Submission Date December 29, 2022
Acceptance Date March 15, 2023
Published in Issue Year 2023 Volume: 4 Issue: Kongre Özel

Cite

APA Küçükosmanoğlu, İ. (2023). KONYA ŞEHİR HASTANESİ PATOLOJİ LABORATUVARINDA İNCELENEN SERVİKAL SİTOLOJİ ÖRNEKLERİNDEKİ YÜKSEK RİSKLİ HPV’LERİN GENOTİP DAĞILIMI VE EPİTELYAL HÜCRE ANOMALİLERİ İLE İLİŞKİSİ. Selçuk Sağlık Dergisi, 4(Kongre Özel), 18-30.