Evaluation of HPV 16 positive cases

Abstract

Objective: The most significant risk factor for cervical cancer is a positive HPV test. Among the types of HPV, types 16 and 18 pose the highest risk. In cases where HPV is found to be positive, particularly in high-risk HPV types, colposcopy and cervical biopsy examination are recommended. Our study will evaluate the smear results of patients who are positive for HPV type 16. Material and Methods: We evaluated the correlation between age and cervical biopsy results in 1062 patients who tested positive for HPV type 16. The age, smear, and colposcopic biopsy results of the cases were recorded. Every woman participating in the screening gave two samples, one for the traditional cytology test and the other for the HPV DNA test. Tissue sampling was performed within a month, including colposcopic biopsy, Loop Electrosurgical Excision Procedure (LEEP), conization, and hysterectomy of 1062 patients. Diagnoses obtained from histological samples were taken as the gold standard. Results: The study included 1062 female patients who tested positive for isolated HPV type 16. The average age of the patients was determined to be 42.02±8.81 (min:21, max:77). When smoking usage was examined, it was found that 482 (45.4%) were smokers, while 580 (54.6%) were non-smokers. 284 (26.7%) of the patients were menopausal. The relationship between age, menopausal status, and smoking usage with smear and colposcopy results in women positive for HPV type 16 was examined. No statistically significant result was found. Conclusion: There is no correlation between age, menopausal status, and smoking usage with smear and colposcopy results in women positive for HPV type 16. The most significant risk factor for abnormal smear and colposcopy results, in line with the literature, is HPV type 16 itself.

Keywords

• Hpv 16
• smear
• colposcopy
• biopsy

HPV 16 pozitif vakaların değerlendirilmesi

Abstract

Amaç: Serviks kanseri için gösterilmiş en önemli risk faktörü HPV pozitifliğidir. HPV tipleri arasında ise en yüksek riske sahip olan tipler ise 16 ve 18’dir. HPV incelemesi sonucunda yüksek riskli HPV tiplerinde kolposkopi ve serviks biyopsisi incelemesi önerilmektedir. Biz bu çalışmada HPV tip 16 pozitif hastaların smear sonuçları değerlendirilmiştir. Gereç ve yöntem: 1062 adet HPV tip 16 pozitif hastanın yaş ile korelasyonunu ve servikal biyopsi sonuçlarını değerlendirdik. Olguların yaş, smear ve kolposkopik biyopsi sonuçları kaydedildi. Taramaya katılan her kadın, biri geleneksel sitoloji testi ve diğeri HPV DNA testi olmak üzere iki örnek alındı. Test sonuçları, hastanemiz Patoloji laboratuvarında 2001 Bethesda sınıflandırması esas alınarak yorumlanmasıyla elde edilmiştir. 1062 hastanın kolposkopik biyopsi, Loop Electrosurgical Excision Procedure (LEEP), konizasyon ve histerektomi dahil olmak üzere bir ay içinde takip doku örneklemesi yapıldı. Histolojik örneklerden elde edilen tanılar altın standart olarak alındı. Bulgular: Çalışmaya izole HPV tip 16 pozitif 1062 kadın hasta dahil edildi. Hastaların ortalama yaşı 42,02±8,81 (min:21, max:77) olarak tespit edildi. Sigara kullanımı incelendiğinde 482 (%45,4)’si sigara kullanmakta olduğu görüldü. Hastaların 284 (%26,7)’ü menopozda idi. HPV tip 16 pozitif kadınlarda smear ve kolposkopi sonuçlarının yaş, menopozla durum, sigara kullanımı ile ilişkisi incelendi. İstatistiksel olarak anlamlı sonuç saptanmadı. Sonuç: HPV tip 16 pozitif kadınlarda smear ve kolposkopi sonuçlarının yaş, menopozla durum ve sigara kullanımı ile ilişkisi yoktur. Anormal smear ve kolposkopi sonucu için en önemli risk faktörü, literatür ile uyumlu olarak, HPV tip 16’nın kendisidir.

Keywords

• Hpv 16
• smear
• kolposkopi
• biyopsi

References

1. 1. Sezgin B, Kinci MF, Pirinççi F, Camuzcuoğlu A, Erel Ö, Neşelioğlu S, et al. Thiol-disulfide status of patients with cervical cancer. J Obstet Gynaecol Res. 2020; 46(11):2423-2429.
2. 2. Shingleton HM, Patrick RL, Johnston WW, Smith RA. The current status of the Papanicolaou smear. CA Cancer J Clin. 1995; 45(5):305-320.
3. 3. Wright TC Jr, Schiffman M. Adding a test for human papillomavirus DNA to cervical-cancer screening. N Engl J Med. 2003;348(6):489-90.
4. 4. Akpak YK, Savasci U, Ören C, Coskun O, Yıldız H, Karagöz E, et al. Health Care Professionals’ Knowledge and Attitudes About Sexually Transmitted Diseases and Legal Aspects of Medical Services. CJMB. 2026; 3(1): 14-18.
5. 5. Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol. 1999; 189(1):12-19.
6. 6. Stănculescu RV, Brătilă E, Bauşic V, Vlădescu TC, Vasilescu F, Bauşic A, et al. Review of the biotechnologies and tests used for precancerous cervical lesions diagnosis. Rom J Morphol Embryol. 2017;58(1):7-14.
7. 7. Kan Ö, Gorkem U, Barış A, Kocak Ö, Togrul C, Yıldırım E. Kanser erken teşhis ve tarama eğitim merkezleri’ne KETEM başvuran kadınlarda Human Papillomavirüs HPV sıklığının değerlendirilmesi ve genotiplerin analizi. Türk Hijyen ve Deneysel Biyoloji Derg. 2019; 76(2): 163–168.
8. 8. Sankaranarayanan R, Basu P, Wesley RS, Mahe C, Keita N, Mbalawa CC, et al. IARC Multicentre Study Group on Cervical Cancer Early Detection. Accuracy of visual screening for cervical neoplasia: Results from an IARC multicentre study in India and Africa. Int J Cancer. 2004;110(6):907-913.

9. 9. Beutner KR, Tyring S. Human papillomavirus and human disease. Am J Med. 1997;102(5):9-15.
10. 10. Muderris T, Afsar I, Yıldız A, Akpınar Varer C. HPV genotype distribution among women with normal and abnormal cervical cytology in Turkey. Rev Esp Quimioter. 2019;32(6):516-524.
11. 11. Taskin MH, Nursal AF, Oruc MA, Kariptas E. Genotype Distribution and Prevalence of High-Risk Human Papillomavirus Infection among Women in Samsun Province of Turkey. Asian Pac J Cancer Prev. 2022;23(7):2477-2482.
12. 12. Dursun P, Senger SS, Arslan H, Kuşçu E, Ayhan A. Human papillomavirus (HPV) prevalence and types among Turkish women at a gynecology outpatient unit. BMC Infect Dis. 2009;30;9:191.
13. 13. Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global Cancer Statistics 2020: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA Cancer J Clin. 2021;71(3):209-249.
14. 14. Lăără E, Day NE, Hakama M. Trends in mortality from cervical cancer in the Nordic countries: association with organised screening programmes. Lancet. 1987;30(1):1247-1249.
15. 15. Paraskevaidis E, Arbyn M, Sotiriadis A, Diakomanolis E, Martin-Hirsch P, Koliopoulos G, et al. The role of HPV DNA testing in the follow-up period after treatment for CIN: a systematic review of the literature. Cancer Treat Rev. 2004; 30(2):205-11.
16. 16. Zito Marino F, Ronchi A, Stilo M, Cozzolino I, La Mantia E, Colacurci N, et al. Multiplex HPV RNA in situ hybridization/p16 immunohistochemistry: a novel approach to detect papillomavirus in HPV-related cancers. A novel multiplex ISH/IHC assay to detect HPV. Infect Agent Cancer. 2020;15(1): 46.
17. 17. Boccardo E, Lepique AP, Villa LL. The role of inflammation in HPV carcinogenesis. Carcinogenesis. 2010; 31(11):1905-12.
18. 18. Koutsky LA, Ault KA, Wheeler CM, Brown DR, Barr E, Alvarez FB, et al. Proof of Principle Study Investigators. A controlled trial of a human papillomavirus type 16 vaccine. N Engl J Med. 2002; 347(21):1645-1651.
19. 19. Mbulawa ZZ, Coetzee D, Williamson AL. Human papillomavirus prevalence in South African women and men according to age and human immunodeficiency virus status. BMC Infect Dis. 2015;26:459.
20. 20. Alotaibi HJ, Almajhdi FN, Alsaleh AN, Obeid DA, Khayat HH, Al-Muammer TA, et al. Association of sexually transmitted infections and human papillomavirus co-infection with abnormal cervical cytology among women in Saudi Arabia. Saudi J Biol Sci. 2020; 27(6):1587-1595.
21. 21. Findik S, Findik S, Abuoğlu S, Cihan FG, Ilter H, Iyisoy MS. 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. Int J Clin Exp Pathol. 2019;12(4):1391-1398.
22. 22. Jans L, Zetterström K, Bergengren L, Helenius G. The value of adding a single co-test in HPV primary screening. Prev Med. 2021; 149:106617.