Flow Cytometric DNA Analysis of Condyloma Accuminata Patients Treated With Two Different Approaches

Öz

Aim: The aim of this study was to evaluate vulvar condylomas by flow cytometric DNA analysis to determine parameters that can show recurrences before treatment.Material And Methods: Of the 27 cases of vulvar condylomas attending to the clinics of Ankara University School of Medicine Obstetrics and Gynecology Department, 16 cases were treated by CO2 laser and 11 cases were treated by intralesional interferon. All cases were analyzed by DNA flow cytometry for the presence of aneuploidy, DNA index and S-phase before treatment.Results: Both treatment groups were similar according to the patient age, disease duration, number of lesions, lesion area, presence of lesion in the partner, smoking habit and surveillance after treatment. The recurrence rates for CO2 laser and intralesional interferon treatment groups were 25% 4/16 and 9% 1/11 , respectively. DNA content analysis of the cases revealed 18.5% diploidy and 81.5% aneuploidy. There was no recurrence in diploid cases. The presence of aneuploidy, DNA index and S-phase were not statistically different between both treatment groups and between cases that showed recurrence or not.Conclusion: Flow cytometric DNA content analysis was not found to be effective in determining recurrences in vulvar condylomas.

Anahtar Kelimeler

• Condyloma accuminata,human papillomavirus,flow cytometry,DNA ploidy

Farklı Tedavi Modaliteleri Uygulanan Kondiloma Akuminata Olgularının Akım Sitometrik DNA Analizi

Öz

Amaç: Çalışmamızda farklı tedavi protokolleri uygulanan vulvar kondiloma akuminata olgularının akım sitometri ile deoksiribo nükleik asit DNA içerikleri analiz edilerek tedavi sonrası rekürrensleri önceden gösterebilecek parametreler olup olmadığı araştırılmıştır.Gereç ve Yöntemler: Ankara Üniversitesi Tıp Fakültesi Kadın Hastalıkları ve Doğum Kliniği’ne başvuran 27 vulvar kondiloma akuminata olgusunun 16 tanesi karbondioksit CO2 lazer kalan 11 olgu intralezyoner interferon ile tedavi edildi. Tüm olguların tedavi öncesi akım sitometri yöntemi ile DNA içerikleri anöploidi varlığı, DNA indeksi ve ortalama S-fazı açısından değerlendirildi.Bulgular: Her iki tedavi grubu hasta yaşı, hastalık süresi, lezyon sayısı, lezyon alanı, partnerde lezyon varlığı, sigara kullanımı ve tedavi sonrası izlem süresi açısından farklılık göstermiyordu. CO2 lazer tedavi grubunda %25 4/16 , intralezyoner interferon grubunda %9 1/11 rekürrens saptandı. Olguların DNA akım sitometrik analizinde olguların %18.5 diploidi, %81,5 anöploidi izlendi. Diploid olan olgularda rekürrens izlenmedi. Anöploidi varlığı, DNA indeksleri ve ortalama S-fazı açısından hem her iki tedavi grubu arasında hem de rekürrens izlenen ve izlenmeyen gruplar arasında istatistiksel farklılık görülmedi.Sonuç: Vulvar kondilomlar için akım sitometri yöntemiyle DNA içerik analizi rekürrensleri belirlemede etkin bulunmamıştır.

Anahtar Kelimeler

• Kondiloma akuminata,human papillomavirüs,akım sitometri,DNA ploidi

Kaynakça

1. Thurgar E, Barton S, Karner C, Edwards SJ. Clinical effectiveness and cost-effectiveness of interventions for the treatment of anogenital warts: systematic review and economic evaluation. Health Technol Assess (Winchester, England). 2016;20(24):1.
2. Ferenczy A, Jenson AB. Tissue effects and host response: the key to the rational triage of cervical neoplasia. Obstet Gynecol Clin North Am. 1996;23(4):759-82.
3. Campion MJ, Greenberg MD, Kazamel TI. Clinical manifestations and natural history of genital human papillomavirus infections. Obstet and Gynecol Clin North Am. 1996;23(4):783-809.
4. Kanev M, Muranlı FG. Flow sitometri ve kullanım alanları. Sakarya Univer- sity Journal of Science. 2016;20(1):33-8.
5. Brown M, Wittwer C. Flow cytometry: principles and clinical applications in hematology. Clin Chem. 2000;46(8):1221-9.
6. Duque RE, Andreeff M, Braylan RC, Diamond LW, Peiper SC. Consensus review of the clinical utility of DNA flow cytometry in neoplastic hemato- pathology. Cytometry. 1993;14(5):492-6.
7. Look AT, Roberson PK, Williams DL, Rivera G, Bowman WP, Pui C-H, et al. Prognostic importance of blast cell DNA content in childhood acute lymphoblastic leukemia. Blood. 1985;65(5):1079-86.
8. Dressler LG, Bartow SA, editors. DNA flow cytometry in solid tumors: practical aspects and clinical applications. Semin Diagn Pathol; 1989.

9. Gunawan B, Granzen B, Keller U, Steinau G, Füzesi L, Schumpelick V, et al. Clinical aspects of alveolar rhabdomyosarcoma with translocation t (1; 13)(p36; q14) and hypotetraploidy. Pathol Oncol Res. 1999;5(3):211-3.
10. Reid R, Greenberg MD, Lörincz AT, Daoud Y, Pizzuti D, Stoler M. Super- ficial laser vulvectomy. IV. Extended laser vaporization and adjunctive 5-fluorouracil therapy of human papillomavirus-associated vulvar dise- ase. Obstet Gynecol. 1990;76(3 Pt 1):439-48.
11. Eron LJ, Judson F, Tucker S, Prawer S, Mills J, Murphy K, et al. Interferon therapy for condylomata acuminata. N Engl J Med. 1986;315(17):1059- 64.
12. Yang J, Pu Y-G, Zeng Z-M, Yu Z-J, Huang N, Deng Q-W. Interferon for the treatment of genital warts: a systematic review. BMC Infect Dis. 2009;9(1):156.
13. Clavel C, Zerat L, Binninger I, Boutterin M-C, Polette M, Monsonego J, et al. DNA content measurement and in situ hybridization in condylomatous cervical lesions. Diagn Mol Pathol. 1992;1(3):180-4.
14. Chacho MS, Eppich E, Wersto R, Koss LG. Influence of human papil- lomavirus on DNA ploidy determination in genital condylomas. Cancer. 1990;65(10):2291-4.
15. Rihet S, Bellaich P, Lorenzato M, Bouttens D, Bernard P, Birembaut P, et al. Human papillomaviruses and DNA ploidy in anal condylomata acuminata. Histol Histopathol. 2000;15(1):79-84.
16. Rihet S, Lorenzato M, Clavel C. Oncogenic human papillomaviruses and ploidy in cervical lesions. J Clin Pathol. 1996;49(11):892-6.
17. Singh M, Mehrotra S, Kalra N, Singh U, Shukla Y. Correlation of DNA ploidy with progression of cervical cancer. J Cancer Epidemiol. 2008;2008(1):1.
18. Lorenzato M, Bory J-P, Cucherousset J, Nou J-M, Bouttens D, Thil C, et al. Usefulness of DNA ploidy measurement on liquid-based smears showing conflicting results between cytology and high-risk human papillomavirus typing. Am J Clin Pathol. 2002;118(5):708-13.
19. Bollmann R, Méhes G, Torka R, Speich N, Schmitt C, Bollmann M. De- termination of features indicating progression in atypical squamous cells with undetermined significance. Cancer. 2003;99(2):113-7.
20. Bollmann M, Várnai Ad, Griefingholt H, Bánkfalvi A, Callenberg H, Speich N, et al. Predicting treatment outcome in cervical diseases using liqu- id-based cytology, dynamic HPV genotyping and DNA cytometry. Anti- cancer Res. 2006;26(2B):1439-46.