Liquid Based Cytology, HPV-DNA Genotype and Evaluation of Colposcopic Biopsy Results: The Analysis of 407 Cases

Year 2022, , 204 - 207, 30.12.2022

Ezgi Işıl Turhan , Melike Nalbant , Mehmet Bayrak

https://doi.org/10.47572/muskutd.896720

Cited By: 1

Abstract

The aim of this study is to determine the most common HPV types in Bursa and to investigate the consistency of concurrent liquid-based cytology and colposcopic biopsy results regarding these types. In our retrospective study, 407 patients, who underwent cervical smear sampling in our hospital between October 2019 and May 2020, and, who were simultaneously diagnosed with high-risk HPV-DNA genotype by real-time PCR method, were included. In our study, our rate of high-risk HPV was 18%. The most common high-risk HPV type was type 16 (32.5%). Considering smear results, ASC-US was found in 28.5%, LSIL was found in 7.7% and HSIL was found in 3.8% with HPV positivity. In 2 of 5 patients with SIL, biopsy showed cervical intraepithelial neoplasia 1 (CINI), and 3 had cervical intraepithelial neoplasia 3 (CIN3). Simultaneous HPV testing with smears increases the sensitivity of the scan and the probability of detecting high-grade lesions.

Keywords

Colposcopic Biopsy, Liquid Based Cytology, High Risk HPV, HPV-DNA

Sıvı Bazlı Sitoloji, HPV-DNA Genotiplendirme ve Kolposkopik Biyopsi Sonuçlarının Değerlendirilmesi: 407 Vakanın Analizi

Abstract

Bu çalışmanın amacı Bursa ilinde en sık rastlanan HPV tiplerini belirlemek, bu tiplerle ilgili olarak eş zamanlı sıvı bazlı sitoloji ve kolposkopik biyopsi sonuçlarının tutarlılığını araştırmaktır. Retrospektif çalışmamıza Ekim 2019-Mayıs 2020 tarihleri arasında hastanemizde servikal smear örneklemesi yapılan ve eş zamanlı olarak real time PCR yöntemi ile yüksek riskli HPV-DNA genotip tayini yapılmış 407 hasta dahil edildi. Çalışmamızda yüksek riskli HPV görülme oranımız %18 bulundu. İzole olarak bakıldığında en sık görülen yüksek riskli HPV tipi, tip 16 (%32.5) bulundu. HPV pozitifliği saptanan 77 hastada smearde %28.5 oranında önemi belirlenemeyen atipik skuamöz hücreler (ASC-US), %7.7 oranında düşük dereceli skuamöz intraepitelyal lezyon (LSIL), %3.8 oranında yüksek dereceli skuamöz intraepitelyal lezyon (HSIL) saptandı. SIL saptanan beş hastanın ikisinde biyopside servikal intraepitelyal neoplazi 1 (CINI), üçünde ise servikal intraepitelyal neoplazi 3 (CIN3) saptanmıştır. HPV testinin smear ile eş zamanlı yapılması taramanın sensivitesini yüksek dereceli lezyonların saptanma olasılığını artırmaktadır.

Keywords

HPV-DNA, Kolposkopik Biyopsi, Sıvı Bazlı Sitoloji, Yüksek Riskli HPV

References

• 1. Türkiye Halk Sağlığı Kurumu, Kanser Daire Başkanlığı, http://kanser.gov.tr/daire- faaliyetleri/kanser-istatistikleri.html
• 2. Ergünay K, Mısırlıoğlu M, Fırat P ve ark. Sitolojik olarak anomali saptanan serviks örneklerinde insan papilloma virus DNA’sının araştırılması ve virusun tiplendirilmesi. Mikrobiyoloji Bült. 2007;41:219-26. 3. The Lancet. Chronic disease management in ageing populations (Editorial). Lancet Oncol 2012;379:1851.
• 4. Serrano B, Alemany L, Ruiz PA, et al. Potential impact of a 9-valent HPV vaccine in HPV-related cervical disease in 4 emerging countries (Brazil, Mexico, India and China). Cancer Epidemiol. 2014;38(6):748- 56.
• 5. Usubütün A, Alemany L, Küçükali T, et al. Human papillomavirus types in İnvasive cervical cancer specimens from Turkey. Int J Gynecol Pathol. 2009;28(6):541-8.
• 6. Wentzensen N., Schiffman M, Palmer T, et al. Triage of HPV Positive Women in Cervical Cancer Screening. J Clin Virol. 2016;76(1):49-55.
• 7. Sasieni P, Castanon A, Cuzick J. Effectiveness of cervical screening with age: population based case-control study of prospectively recorded data. BMJ. 2009;339:b2968.
• 8. Vijayaraghavan A, Efrusy M, Mazonson P, et al. Cost-effectiveness of using Human papillomavirus 16/18 genotype triage in cervical cancer screening. Gynecol Oncol. 2010;119(2):237–42.
• 9. Koliopoulos G, Arbyn M, Martin-Hirsch P, et al. Diagnostic accuracy of human papillomavirus testing in primary cervical screening: A systematic review and meta-analysis of nonrandomized studies. Gynecol Oncol. 2007;104(1):232–46.
• 10. Franco EL, Duarte-Franco E, Ferenczy A. Cervical cancer: epidemiology, prevention and the role of human papillomavirus infection. Can Med Assoc J. 2001;164:1017-25.
• 11. Cronje HS. Screening for cervical cancer in developing countries. Int J Gynecol Oncol. 2004;84:101-8.
• 12. Molijn A, Kleter B, Quint W, et al. Molecular diagnosis of human papillomavirus (HPV) infections. J Clin Virol. 2005;32:43-51.
• 13. Munoz N, Bosch FX, Sanjose S., et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer, N Engl J Med. 2003;348:518–27.
• 14. Smith JS, Lindsay L, Hoots B. et al. Human papillomavirus type distribution in invasive cervical cancer and high-grade cervical lesions: a meta-analysis update, Int J Cancer. 2007;121;621–32.
• 15. Cheung TH, Yim SF, Yu MY, et al. Liquid biopsy of HPV DNA in cervical cancer. J Clin Virol. 2019;114:32‐6.
• 16. Dursun P, Ayhan A, Mutlu L, et al. HPV types in Turkey: multicenter hospital based evaluation of 6388 patients in Turkish gynecologic oncology group centers. Turk Patoloji Derg. 2013;29(3):210‐16.
• 17. Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. J Low Genit Tract Dis. 2012;16:175-204.
• 18. Ronco G, Dillner J, Elfström KM, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials [published correction appears in Lancet. 2014;383(9916):524‐32.