Servikal örneklerde HPV-DNA Pozitiflik Oranı ve Sitopatolojik Sonuçların Değerlendirilmesi

Year 2020, Volume: 77 Issue: 1, 33 - 40, 01.03.2020

Özlem Aydemir Hüseyin Agah Terzi Mehmet Köroğlu Gupse Turan Mustafa Altındiş Engin Karakeçe

Abstract

Amaç: Servikal kanser tüm dünyada kadınlar arasında en yaygın görülen ikinci kanser türüdür. Human papilloma virus HPV servikal kanser ile ilişkisi gösterilmiş majör etiyolojik ajandır. HPV’nin bugüne kadar 200’den fazla türü belirlenmiş ve bunlardan 40 tanesinin genital sistemde enfeksiyon yaptığı bilinmektedir. Bu çalışmanın amacı; HPV DNA araştırılması için laboratuvarımıza gönderilen servikal örneklerde HPV DNA varlığını ve HPV genotiplerini belirlemek, aynı zamanda HPV pozitif hastalarda gelişen sitopatolojik değişiklikleri incelemektir.Yöntem: 01 Ocak 2015 - 30 Ocak 2018 tarihleri arasında Kadın Hastalıkları ve Doğum polikliniğine başvuran 20-66 yaş arası hastalardan alınan 1068 servikal sürüntü örneği çalışmaya dahil edildi. Alınan örneklerde DNA izolasyonu için QIAamp®DNA Mini Kit Qiagen, Almanya , PCR ve pyrosequencing yöntemi ile HPV tiplendirme aşamasında HPVsign® Q24 complate Diatech Pharmocogenetics, İtalya kiti kullanıldı.Bulgular: 1068 örneğin 226 %21,1 tanesinde HPV DNA pozitif olarak saptandı. HPV DNA pozitif bulunan örneklerin 141’inde %62.3 yüksek riskli tipler tek başına saptandı. HPV DNA pozitif bulunan örneklerin içinde 73 %32,3 hastada tek başına HPV tip 16 saptanırken 37 types were found in 37 16.3% patients and other types were found in 116 patients. HPV DNA positivity was highest in the 20-30 age group 26.3% . Cytology positivity was found in 20 8.8% of the patients with HPV DNA positivity. Of these patients, 13 had LSIL 65% , 4 20% had HGSIL, 1 5% had ASCUS, 2 10% had HGSIL / seviks CA.Conclusion: This is the first comprehensive study conducted in our region. The rate of HPV DNA positivity detected in cervical swab specimens and the frequency of HPV type 16 were found to be somewhat higher than the rates found in other studies in our country. More extensive work is needed to determine the type of HPV DNA and HPV type prevalence and the types of HPV that should be used in our country

Keywords

Human papilloma virus, servikal kanser, prevalans

Evaluation of HPV-DNA Positivity Rate and Cytopathologic Results in Cervical Specimens

Abstract

Objective: Cervical cancer is the second most common cancer type among women all over the world. Human papilloma virus HPV is the major etiologic agent associated with cervical cancer. More than 200 species of HPV have been identified so far and 40 of them are known to infect the genital system. The aim of this study was to determine the presence of HPV DNA and HPV genotypes in the cervical samples sent to our laboratory for HPV DNA investigation and to investigate the cytopathological changes in HPV positive patients.Methods: A sample of 1068 cervical swabs taken from patients between the ages of 20 and 66 applied to the Obstetrics and Gynecology Clinic between 01 January 2015 and 30 January 2018 were included in the study. HPVsign® Q24 complate kit Qiagen, Germany was used for HPV typing with QIAamp® DNA Mini Kit PCR Diatech Pharmocogenetics, Italy and pyrosequencing for DNA isolation.Results: HPV DNA was detected as positive in 226 21.1% samples of 1068 samples. In 141 62.3% of the HPV DNA positive specimens, high-risk types were detected alone. Among HPV DNA positive samples, HPV type 16 was found in 73 32.3% patients alone, multiple ailesine ait, zarfsız, 55 nm çapında, ikozahedral Human Papillomavirus HPV Papillomaviridae types were found in 37 16.3% patients and other types were found in 116 patients. HPV DNA positivity was highest in the 20-30 age group 26.3% . Cytology positivity was found in 20 8.8% of the patients with HPV DNA positivity. Of these patients, 13 had LSIL 65% , 4 20% had HGSIL, 1 5% had ASCUS, 2 10% had HGSIL / seviks CA.Conclusion: This is the first comprehensive study conducted in our region. The rate of HPV DNA positivity detected in cervical swab specimens and the frequency of HPV type 16 were found to be somewhat higher than the rates found in other studies in our country. More extensive work is needed to determine the type of HPV DNA and HPV type prevalence and the types of HPV that should be used in our country

Keywords

Human papilloma virus, cervical canser, prevalence

References

• 1. Xu H H, Lin A, Chen Y, Dong S, Shi W, Y Jia et al. Prevalence characteristics of cervical human papillomavirus (HPV) genotypes in the Taizhou area, China: a cross sectional study of 37967 women from the general population. BMJ Open, 2017;7:e014135.
• 2. Aziz H, Iqbal H, Mahmood H, Fatima S, Faheem M, Sattar AA, et al. Human papillomavirus infection in females with normal cervical cytology: genotyping and phylogenetic analysis among women in Punjab, Pakistan. Int J Infect Dis, 2018; 66: 83-9.
• 3. Coscia MF, Monno R, Ballini A, Mirgaldi R, Dipalma G, Pettini F et al. Human papilloma virus (HPV) genotypes prevalence in a region of South Italy (Apulia). Ann Ist Super Sanità, 2015; 51(3): 248-25.
• 4. Aslan FG, Us T, Kaşifoğlu N, Özalp SS, Akgün Y, Öge T, ve ark. Eskişehir bölgesindeki kadınlarda human papillomavirus DNA pozitifliği ve olası risk faktörlerinin değerlendirilmesi; TAF Prev Med Bull, 2015; 14(3): 222-28.
• 5. Nascimento M DSB, Vidal BFC, Silva MACN, Batista JE, Barbosa MCL, Filho WEM et al. Prevalence of human papillomavirus infection among women from quilombo communities in northeastern Brazil. BMC Women’s Health. 2018; 18(1).
• 6. Dursun P, Senger SS, Arslan H, Kuşcu E, Ayhan A. Human papillomavirus (HPV) prevalence and types among Turkish women at a gynecology outpatient unit. BMC Infect Dis, 2009; 9:191.
• 7. Fındık D, Dağı HT, Arslan U, Fındık Y. Servikal örneklerde human papillomavirus sıklığı ve genotip dağılımı. Genel Tıp Derg, 2012; 22(4): 116-20.
• 8. Akcali S, Goker A, Ecemis T, Kandiloglu AR, Sanlidag T. Human papilloma virus frequency and genotype distributionin a Turkish population. Asian Pac J Cancer Prev, 2013; 14(1): 503-6.
• 9. Yıldırım D. Sivas Yöresinde Human Papillomavirüs İnfeksiyonları¬nın Araştırılması. Uzmanlık tezi. Cumhuriyet Üniversitesi Tıp Fakültesi Mikrobiyoloji Anabilim Dalı, 2012.
• 10. Inal MM, Köse Ş, Yıldırım Y, Özdemir Y, Töz E, Ertopçu K, et al. The relationship between human papillomavirus infection and cervical intraepithelial neoplasia in Turkish women. Int J Gyna Cancer. 2007:17(6):1266-70.
• 11. Vardar MA, Altıntaş A, Doran F, Arıdogan N, Demir C, Burgut R. et al. Human papillomavirus detection in cervical smears and cervical tissue excised by the loop electrosurgical excision procedure (LEEP). diagnostic value of cytology, colposcopy and histology. Eur J Gynaecol Oncol, 1995:16(6): 494-9.
• 12. Özalp S, Us T, Arslan E, Öge T, Kaşifoğlu N. HPV DNA and pap smear test results in cases with and without cervical pathology. J Turk Ger Gynecol Assoc. 2012: 13(1): 8-14.
• 13. Sanjose S, Diaz M, Castellsague X, Clifford G, Bruni L, Munoz N, et al. Worldwide prevalence and genotype distribution of cervical human papillomavirus DNA in women with normal cytology: a meta-analysis. The Lancet Infect Dis, 2007:7(7): 453-9.
• 14. De Vuyst H, Clifford G, Li N, Franceschi S. HPV infection in Europe. Eur J Cancer, 2009: 45(15): 2632-9.
• 15. Akarolo-Anthony SN, Famooto AO, Dareng EO, Olaniyan OB, Offiong R,Wheeler CM, Adebamowo CA. Age-specific prevalence of human papilloma virus infection among Nigerian women. BMC Public Health. 2014:14(1):656.
• 16. Watson-Jones D, Baisley K, Brown J, Kavishe B, Andreasen A, Changalucha J, et al. High prevalence and incidence of human papillomavirus in a cohort. Sex Transm Infect, 2013; 89: 358–65.
• 17. Cronje HS. Screening for cervical cancer in developing countries. Int J Gynecol Oncol, 2004; 84:101-8.
• 18. Açikgöz A, Ergör G. Cervical cancer risk levels in Turkey and complianc to the national cervical cancer screening standard. Asian Pac J Cancer Prev, 2011;12(4):923-7.
• 19. Özmen V, Dağoğlu N, Dede İ, Akçakaya A, Kerem M, Göksel F, et al. Turkish ministry of health, 2nd Turkish medical general assembly clinical oncology study group report. J Breast Health, 2016;12(1):9- 17.
• 20. Ortiza AP, Tortolero-Lunaa G, Romaguerac J, Pérezb CM, Gonzálezb D, Muñoza C, et al. Seroprevalence of HPV 6, 11, 16 and 18 and correlates of exposure in unvaccinated women aged 16–64 years in Puerto Rico. Papillomavirus Res, 2018: 5:109–13.
• 21. Xue H, Lin X, Li T, Yan X, Guo K, Zhang Y. Prevalence and genotype distribution of human papillomavirus infection in asymptomatic women in Liaoning province, China. J Med Virol, 2015;87(7):1248–53.
• 22. Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, et al.Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine, 2008; 26(1); 1–16.
• 23. Casalegno JS, Benchaib M, Le Bail Carval K, Piaton E, Mathevet P, et al. Human papillomavirus genotype distribution among French women with and without cervical abnormalities. Int J Gynaecol Obstet, 2011;114(2): 116–9.
• 24. Koyuncu E. Taksim Eğitim ve Araştırma Hastanesi, Kadın Hastalıkları ve Doğum Polikliniği’ne Başvuran Hastaların Servikal Sitolojilerin Servikal Kanser Risk Faktörlerine Göre Analizi–Normal ve Anormal Sitolojik Sonuçlarda Yüksek Onkojenik Hpv Prevalansı. Uzmanlık Tezi, Taksim Eği¬tim ve Araştırma Hastanesi Kadın Hastalıkları ve Doğum Kliniği, . İstanbul; 2006.
• 25. Şahiner F, Gümral R, Şener K, Yiğit N, Dede M, Yapar M. Servikal sürüntü örneklerinde iki farklı yöntemle HPV-DNA varlığının araştırılması: MY09/11 Konsensus PCR ve Tipe Özgül Gerçek Zamanlı PCR. Mikrobiyol Bul. 2012; 46: 624-36.
• 26. Aydoğan S, Yazgan A, Taş EE, Gözalan A, Yavuz F, Açıkgöz ZC. Eş zamanlı servikal sitoloji örneklerinde yüksek riskli HPV tiplerinin varlığı ve dağılımı. Turk Hij Den Biyol Derg, 2018; 75(1): 13 – 20.