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Eş zamanlı servikal sitoloji örneklerinde yüksek riskli HPV tiplerinin varlığı ve dağılımı

Year 2018, Volume: 75 Issue: 1, 13 - 20, 01.03.2018

Abstract

Amaç: Human papillomavirus, reprodüktif sistemin en sık görülen viral enfeksiyon etkenidir ve neredeyse tüm serviks kanseri olgularıyla ilişkisi gösterilmiştir. Servikal kanser tarama programları ile erken tanı ve tedavi sayesinde insidans ve mortalite oranları etkin şekilde azalmaktadır. Bu çalışmada üç yıllık bir süre içinde çalışılan HPV DNA test sonuçları ve eş zamanlı servikal sitoloji örneklerinin değerlendirilmesi amaçlanmıştır. Yöntem: 2012-2014 yılları arasında Moleküler Mikrobiyoloji Laboratuvarı’na HPV DNA araştırılması ve genotip tayini amacıyla gönderilen 328 hastaya ait tesrt sonuçları retrospektif olarak analiz edilmiştir. Hastaların sitoloji sonuçları eş zamanlı olarak patoloji laboratuvarı tarafından retrospektif olarak değerlendirilmiş, gerek duyulan örnekler tekrar incelenerek servikal anormallikler ile HPV varlığı ve genotipler arasındaki ilişkiler ortaya konulmuştur. Servikal örnek alımında DigeneHC2 DNA Collection Device® kullanılmış ve DNA eldesi QIAamp® DNA Mini Kit ile yapılmıştır. DNA örneklerinde yüksek riskli HPV tiplerinin varlığı Genotyping Kit HPV GP kullanılarak araştırılmıştır. Sitolojik değerlendirme konvansiyonel Papanicolau testi ile yapılmış ve sonuçlar 2001 Bethesda Sistemi’ne göre yorumlanmıştır. Bulgular: Hastaların yaş ortancası 36 olup, test sonucu pozitif ve negatif kadınların yaş ortancaları arasında anlamlı fark bulunmamıştır. Yüksek riskli HPV DNA analizi yapılan 328 hastanın 110 tanesinde %33.5 pozitif sonuç elde edilmiş ve %22.7 oranında multiple tip varlığı bulunmuştur. En sık saptanan tipler HPV16/51/18/56 olarak belirlenmiştir. Hastaların 270’inde eş zamanlı sitolojik değerlendirme yapılmış ve %21.5 anormal sitoloji saptanmıştır. Anormal sitoloji saptanan hastaların sitolojik bulgulara göre dağılımı; %48.3 ASCUS, %34.5 LSIL, %7 ASC-H, %7 HSIL ve %3.5 AGUS şeklinde olmuştur. Anormal sitoloji saptanan hastalardaki HPV pozitifliği %50 , normal sitolojili hastalardaki HPV pozitifliğinden %28.3 istatistiksel olarak anlamlı derecede yüksek bulunmuştur p=0.002 . Çalışmamızda Tip 16, anormal sitolojili grupta %38, normal sitolojili grupta ise %44 oranında saptanmıştır. Sonuç: Servikal kanser tarama programları tüm dünyada hızla önem kazanırken, HPV genotipleme önemli rol üstlenmektedir. Normal sitolojili hastalarda da Tip 16’nın yüksek oranda saptanması, sitolojik incelemenin mutlaka DNA çalışması ile desteklenmesi ve hastaların yakın takibe alınması gerekliliğini kanıtlamaktadır.

References

  • 1. Catarino R, Petignat P, Dongui G, Vassilakos P. Cervical cancer screening in developing countries at a crossroad: Emerging Technologies and policy choices. World J Clin Oncol 2015; 6(6):281-90.
  • 2. World Health Organization. Human papillomavirus (HPV) and cervical cancer. Reviewed March 2015. Available from: URL: http://www.who.int/ mediacentre/factsheets/fs380/en/.
  • 3. T.C. Saglik Bakanligi, Turkiye Halk Sagligi Kurumu, Turkiye Kanser İstatistikleri Ankara 2016. URL: http://kanser.gov.tr/Dosya/ca_istatistik/ANA_ rapor_2013v01_2.pdf.
  • 4. Egawa N, Egawa K, Griffin H, and Doorbar J. Human papillomaviruses; epithelial tropisms. and the development of neoplasia. Viruses 2015; 7:3863-90.
  • 5. McGraw SL, Ferrante JM. Update on prevention and screening of cervical cancer. World J Clin Oncol 2014;5(4):744-52.
  • 6. Choi YJ, Park JS. Clinical significance of human papillomavirus genotyping. J Gynecol Oncol. 2016; 27(2):e21.
  • 7. Sahiner F. Current prıblems and recent advances in the molecular diagnosis of genital human papillomavirus infections. Mikrobiyol Bul 2014; 48(4):689-706.
  • 8. Abreu ALP, Souza RP, Gimenes F, Consolaro MEL. A review of methods for detect human papillomavirus infection. Virology Journal 2012;9:262.
  • 9. 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.
  • 10. Fongmoon D, Nakong M, Lalitwongsa S, Keyoonwong W. Prevalance and genotypic distribution of high risk humanpapillomavirus infection among women screened for cervical cancer at Lampang Cancer Hospital. Bull Chiang Mai Assoc Med Sci 2015; 48(3):231-40.
  • 11. Sankaranarayanan R. Screening for cancer in low and middle income countries. Annals of Global Health 2014; 80:412-17.
  • 12. Zong LJ, Zhang Y-Z, Yang X-S, Jiang J, Cui B-X, Qiao Y-B, et al. Evaluation of several screening approaches for detection of cervical lesions in rural Shandong, China. Asian Pac J Cancer Prev 2015; 16(5):1907-12.
  • 13. Eren F, Erenus M, Bas E, Ahiskali R, Yoldemir T. Prevalance of HPV infection by cytologic diagnosis and HPV DNA extraction and prevalance of the HPV genotypes detected in urban Turkish women. Int J Gynecol Obstet 2010; 109:235-38.
  • 14. Yuce K, Pinar A, Salman MC, Alp A, Sayal B, Dogan S, Hascelik G. Detection and genotyping of cervical HPV with simultaneous cervical cytology in Turkish women: a hospital based study. Arch Gynecol Obstet 2012; 286:203-8.
  • 15. Akyar I, Aydın O, Yakicier MC, Kocagoz ZT, Ince U, Unsal I. Human papillomavirus prevalance and type in liquid-based cervical samples from Turkish women in a selected risk group. Turk J Med Sci 2013; 43:963-70.
  • 16. Akcali S, Goker A, Ecemis T, Kandiloglu AR, Sanlidag T. Human papillomavirus frequency and genotype distribution in a Turkish population. Asian Pacific J Cancer Prev; 2013; 14(1):503-6.
  • 17. Dursun P, Senger SS, Arslan H, Kuscu E, and Ayhan A. Human papillomavirus (HPV) prevalance and types among Turkish women at a gynecology outpatient unit. BMC Infect Dis 2009; 9:191.
  • 18. Ozalp S, Us T, Arslan E, Oge T, Kasifoglu N. HPV DNA and Pap smear results in cases with and without cervical pathology. J Turkish-German Gynecol Assoc 2012; 13:8-14.
  • 19. Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalance of cervical cytological abnormalities in Turkey. Int J Gynecol Obstet 2009; 106:206-9.
  • 20. Altun Z, Yarkın F, Vardar MA, Uguz AH. The prevalance of human papillomavirus infection among women who admitted to Çukurova University Faculty of Medicine Hospital. Turkiye Klinikleri J Med Sci 2011; 31(2):307-14.
  • 21. Salazar KL, Zhou HS, Xu J., Peterson LE, Schwartz MR, Mody DR, Ge Y. Multiple human papillomavirus infections and their impact on the development of high-risk cervical lesions. Acta Cytologica 2015; 59:391-98.
  • 22. Nakalembe M, Mirembe FM, Banura C. Vaccines against human papillomavirus in low and middle income countries: a review of safety, immunogenicity and efficacy. Infect Agent Cancer 2015; 10:17.
  • 23. Dede M. Profilaktik HPV aşıları: güncel yaklaşımlar. Gülhane Tıp Derg 2010; 52:148-56.

The presence and distribution of high risk HPV types in simultaneous cervical cytology samples

Year 2018, Volume: 75 Issue: 1, 13 - 20, 01.03.2018

Abstract

Objective: Human papillomavirus HPV is the most detected viral pathogen of reproductive system and almost all servical carsinomas are related to HPV. The incidance and mortality rate of cervical carsinomas are significantly decrease by means of early diagnosis and treatment owing to servical cancer screening programmes. The aim of the study is to evaluate the results of HPV DNA tests and cervical cytology specimens simultaneously in a three year period. Methods: The test results of 328 patients that were send to determine Molecular Microbiology Laboratory for HPV DNA and genotype between 2012-2014 were retrospectively analysed. Moreover, the cytology results of the same patient group were reviewed simultaneously by pathologist and reexamined if necessary. The relationship between cervical anomalies and the presence of HPV DNA and genotypes were exhibited. Cervical samples were collected in DigeneHC2 DNA Collection Device and DNA was isolated using QIAamp DNA Mini Kit. DNA samples were tested for high risk HPV infection by the Genotyping Kit HPV GP. Cytological examination were done by using conventional Papanicolaou method and interpreted according to 2001 Bethesda System.Results: The median age of the patients was found 36 and there was no significant difference between the median ages of the HPV DNA negative and positive women. High risk HPV DNA was determined 110 out of 328 patients 33.5% and multiple types were detected 22.7% of the cases. The most determined types were HPV-16/51/18 and 56 respectively. Abnormal cytology was detected from 21.5% of the 270 patients that were evaluated by pathologist simultaneously. The abnormal cytologic signs of the patients were reported as 48.3% ASCUS, 34.5% LSIL, 7% ASC-H, 7% HSIL and 3.5% AGUS. The HPV DNA positivity of the patients with abnormal cytologic results 50% were found high significantly comparing the patients with normal cytology 28.3% p=0.002 . The type 16 was determined 38% and 44% from the patients with abnormal and normal cytology, respectively. Conclusion: The genotyping of HPV plays an important role while the cervical cancer screening programmes have gaining importance globally. The determination of high rates of type 16 from patients with normal cytology proves that cytologic evaluation should be supported by DNA typing and those patients should be followed up closely.

References

  • 1. Catarino R, Petignat P, Dongui G, Vassilakos P. Cervical cancer screening in developing countries at a crossroad: Emerging Technologies and policy choices. World J Clin Oncol 2015; 6(6):281-90.
  • 2. World Health Organization. Human papillomavirus (HPV) and cervical cancer. Reviewed March 2015. Available from: URL: http://www.who.int/ mediacentre/factsheets/fs380/en/.
  • 3. T.C. Saglik Bakanligi, Turkiye Halk Sagligi Kurumu, Turkiye Kanser İstatistikleri Ankara 2016. URL: http://kanser.gov.tr/Dosya/ca_istatistik/ANA_ rapor_2013v01_2.pdf.
  • 4. Egawa N, Egawa K, Griffin H, and Doorbar J. Human papillomaviruses; epithelial tropisms. and the development of neoplasia. Viruses 2015; 7:3863-90.
  • 5. McGraw SL, Ferrante JM. Update on prevention and screening of cervical cancer. World J Clin Oncol 2014;5(4):744-52.
  • 6. Choi YJ, Park JS. Clinical significance of human papillomavirus genotyping. J Gynecol Oncol. 2016; 27(2):e21.
  • 7. Sahiner F. Current prıblems and recent advances in the molecular diagnosis of genital human papillomavirus infections. Mikrobiyol Bul 2014; 48(4):689-706.
  • 8. Abreu ALP, Souza RP, Gimenes F, Consolaro MEL. A review of methods for detect human papillomavirus infection. Virology Journal 2012;9:262.
  • 9. 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.
  • 10. Fongmoon D, Nakong M, Lalitwongsa S, Keyoonwong W. Prevalance and genotypic distribution of high risk humanpapillomavirus infection among women screened for cervical cancer at Lampang Cancer Hospital. Bull Chiang Mai Assoc Med Sci 2015; 48(3):231-40.
  • 11. Sankaranarayanan R. Screening for cancer in low and middle income countries. Annals of Global Health 2014; 80:412-17.
  • 12. Zong LJ, Zhang Y-Z, Yang X-S, Jiang J, Cui B-X, Qiao Y-B, et al. Evaluation of several screening approaches for detection of cervical lesions in rural Shandong, China. Asian Pac J Cancer Prev 2015; 16(5):1907-12.
  • 13. Eren F, Erenus M, Bas E, Ahiskali R, Yoldemir T. Prevalance of HPV infection by cytologic diagnosis and HPV DNA extraction and prevalance of the HPV genotypes detected in urban Turkish women. Int J Gynecol Obstet 2010; 109:235-38.
  • 14. Yuce K, Pinar A, Salman MC, Alp A, Sayal B, Dogan S, Hascelik G. Detection and genotyping of cervical HPV with simultaneous cervical cytology in Turkish women: a hospital based study. Arch Gynecol Obstet 2012; 286:203-8.
  • 15. Akyar I, Aydın O, Yakicier MC, Kocagoz ZT, Ince U, Unsal I. Human papillomavirus prevalance and type in liquid-based cervical samples from Turkish women in a selected risk group. Turk J Med Sci 2013; 43:963-70.
  • 16. Akcali S, Goker A, Ecemis T, Kandiloglu AR, Sanlidag T. Human papillomavirus frequency and genotype distribution in a Turkish population. Asian Pacific J Cancer Prev; 2013; 14(1):503-6.
  • 17. Dursun P, Senger SS, Arslan H, Kuscu E, and Ayhan A. Human papillomavirus (HPV) prevalance and types among Turkish women at a gynecology outpatient unit. BMC Infect Dis 2009; 9:191.
  • 18. Ozalp S, Us T, Arslan E, Oge T, Kasifoglu N. HPV DNA and Pap smear results in cases with and without cervical pathology. J Turkish-German Gynecol Assoc 2012; 13:8-14.
  • 19. Turkish Cervical Cancer and Cervical Cytology Research Group. Prevalance of cervical cytological abnormalities in Turkey. Int J Gynecol Obstet 2009; 106:206-9.
  • 20. Altun Z, Yarkın F, Vardar MA, Uguz AH. The prevalance of human papillomavirus infection among women who admitted to Çukurova University Faculty of Medicine Hospital. Turkiye Klinikleri J Med Sci 2011; 31(2):307-14.
  • 21. Salazar KL, Zhou HS, Xu J., Peterson LE, Schwartz MR, Mody DR, Ge Y. Multiple human papillomavirus infections and their impact on the development of high-risk cervical lesions. Acta Cytologica 2015; 59:391-98.
  • 22. Nakalembe M, Mirembe FM, Banura C. Vaccines against human papillomavirus in low and middle income countries: a review of safety, immunogenicity and efficacy. Infect Agent Cancer 2015; 10:17.
  • 23. Dede M. Profilaktik HPV aşıları: güncel yaklaşımlar. Gülhane Tıp Derg 2010; 52:148-56.
There are 23 citations in total.

Details

Primary Language English
Journal Section Research Article
Authors

Sibel Aydoğan This is me

Aylin Yazgan This is me

Emre Erdem Taş This is me

Ayşegül Gözalan This is me

Ayşe Filiz Yavuz This is me

Ziya Cibali Açıkgöz This is me

Publication Date March 1, 2018
Published in Issue Year 2018 Volume: 75 Issue: 1

Cite

APA Aydoğan, S., Yazgan, A., Taş, E. E., Gözalan, A., et al. (2018). The presence and distribution of high risk HPV types in simultaneous cervical cytology samples. Türk Hijyen Ve Deneysel Biyoloji Dergisi, 75(1), 13-20.
AMA Aydoğan S, Yazgan A, Taş EE, Gözalan A, Yavuz AF, Açıkgöz ZC. The presence and distribution of high risk HPV types in simultaneous cervical cytology samples. Turk Hij Den Biyol Derg. March 2018;75(1):13-20.
Chicago Aydoğan, Sibel, Aylin Yazgan, Emre Erdem Taş, Ayşegül Gözalan, Ayşe Filiz Yavuz, and Ziya Cibali Açıkgöz. “The Presence and Distribution of High Risk HPV Types in Simultaneous Cervical Cytology Samples”. Türk Hijyen Ve Deneysel Biyoloji Dergisi 75, no. 1 (March 2018): 13-20.
EndNote Aydoğan S, Yazgan A, Taş EE, Gözalan A, Yavuz AF, Açıkgöz ZC (March 1, 2018) The presence and distribution of high risk HPV types in simultaneous cervical cytology samples. Türk Hijyen ve Deneysel Biyoloji Dergisi 75 1 13–20.
IEEE S. Aydoğan, A. Yazgan, E. E. Taş, A. Gözalan, A. F. Yavuz, and Z. C. Açıkgöz, “The presence and distribution of high risk HPV types in simultaneous cervical cytology samples”, Turk Hij Den Biyol Derg, vol. 75, no. 1, pp. 13–20, 2018.
ISNAD Aydoğan, Sibel et al. “The Presence and Distribution of High Risk HPV Types in Simultaneous Cervical Cytology Samples”. Türk Hijyen ve Deneysel Biyoloji Dergisi 75/1 (March 2018), 13-20.
JAMA Aydoğan S, Yazgan A, Taş EE, Gözalan A, Yavuz AF, Açıkgöz ZC. The presence and distribution of high risk HPV types in simultaneous cervical cytology samples. Turk Hij Den Biyol Derg. 2018;75:13–20.
MLA Aydoğan, Sibel et al. “The Presence and Distribution of High Risk HPV Types in Simultaneous Cervical Cytology Samples”. Türk Hijyen Ve Deneysel Biyoloji Dergisi, vol. 75, no. 1, 2018, pp. 13-20.
Vancouver Aydoğan S, Yazgan A, Taş EE, Gözalan A, Yavuz AF, Açıkgöz ZC. The presence and distribution of high risk HPV types in simultaneous cervical cytology samples. Turk Hij Den Biyol Derg. 2018;75(1):13-20.