Research Article
BibTex RIS Cite

Çoklu HPV DNA pozitifliğinin kolposkopik biyopsi sonuçları ile ilişkisi

Year 2026, Volume: 9 Issue: 2, 365 - 369, 12.03.2026
https://izlik.org/JA83WG22ML

Abstract

Amaç: Bu çalışmada çoklu HPV DNA pozitifliklerinin servikal yüksek dereceli lezyonlarla veya servikal kanserle ilişkisinin araştırılması amaçlanmıştır.
Gereçler ve Yöntem: Kadın Hastalıkları ve Doğum Kliniği’nde kolposkopik biyopsi uygulanmış 164 hastanın medikal kayıtları retrospektif olarak analiz edilerek, PAP smear sonucu: (LGSIL - ASCUS - ASC-H)-HPV testi (pozitif) - HPV alt tiplemeleri incelenmiştir. Olgular ; Grup I (negatif, LSIL, koilositoz ve CIN I) ve Grup II (HSIL, CIN II-III, skuamöz karsinom) olmak üzere 2 gruba ayrılmıştır.
Bulgular: Çalışma sonucunda hastaların bazı demografik özellikleri (yaş, parite, menstruasyon durumu), çoklu veya tekli HPV alt tipleri açısından pozitif olma durumları ile kolposkopik biyopsi sonuçları arasında istatistiksel olarak anlamlı fark saptanmamıştır.
Sonuç: Çoklu HPV enfeksiyonlarının servikal displazi ve kanser üzerindeki etkisini aydınlatmak için daha büyük kohortları içeren çalışmalara ihtiyaç vardır.
Anahtar Kelimeler: Çoklu HPV enfeksiyonu, Rahim ağzı kanseri, İnsan papilloma virüsü, Tarama
Kısaltmalar: HPV, Human papilloma virus; PAP, Papanicolaous; CIN, Cervical intraepithelial neoplasms; LSIL, Low grade squamous intraepithelial lesion; HSIL, High grade squamous intraepithelial lesion; ASCUS, Atypical squamous cell of undetermined significance; ASC-H, Atypical squamous cell- cannot exclude HSIL

Ethical Statement

Çalışmanın etik izni 2017-597 proje numarası ve 17.08.2017 tarihi ile alınmıştır.

Supporting Institution

Bu çalışma herhangi bir kurum tarafından desteklenmemiştir.

Project Number

2017-597

Thanks

Çalışma süreci boyunca veri toplama aşamasına destek veren tüm klinik personeline teşekkürlerimizi sunarız. Bu makalenin bazı bölümleri, yalnızca dil açıklığını, yazım kurallarını ve tutarlılığı artırmak amacıyla yapay zekâ tabanlı araçlar kullanılarak düzenlenmiştir. Tüm bilimsel içerik, veri yorumları ve sonuçlar tamamen araştırmacılar tarafından oluşturulmuş, doğrulanmış ve onaylanmıştır.

References

  • Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8:e191-203. doi:10.1016/S2214-109X(19)30482-6
  • Bruni L, Albero G, Serrano B, et al. Human Papillomavirus and Related Diseases in the World. Summary Report 2023. Institut Català d’Oncologia. 2023.
  • Markowitz LE, Dunne EF, Saraiya M, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2014;63(RR-05):1-30.
  • Arbyn M, Sasieni P, Meijer C, Clavel C, Koliopoulos G, Dillner J. Clinical applications of HPV testing: a summary of meta-analyses. Vaccine. 2006;24(Suppl 3):S3/78-89. doi:10.1016/j.vaccine.2006.05.115
  • Trottier H, Mahmud S, Costa MC, et al. Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1274-1280. doi:10.1158/1055-9965.EPI-06-0129
  • ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Cancer. Fact Sheet 2023. Institut Català d’Oncologia, Barcelona, Spain. 2023.
  • Dursun P, Ayhan A, Mutlu L, Güngör M, Haberal A. Servikal kanser öncülü lezyonlarda HPV tip dağılımı. Turk Patoloji Derg. 2013;29:210-216. doi:10.5146/tjpath.2013.01178
  • Bruno MT, Scalia G, Cassaro N, Boemi S. Multiple HPV 16 infection with two strains: a possible neoplastic progression marker. BMC Cancer. 2020;20(1):444. doi:10.1186/s12885-020-06916-9
  • Muñoz N, Bosch FX, de Sanjosé S, et al. Epidemiological classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348(6):518-527. doi:10.1056/NEJMoa021641
  • Paavonen J, Naud P, Salmerón J, et al. Efficacy of HPV-16/18 AS04-adjuvanted vaccine (PATRICIA). Lancet. 2009;374:301-314. doi:10.1016/S0140-6736(09)61248-4
  • Karabulutlu Ö, Pasinlioğlu T. Alanı sağlıkla ilgili olmayan akademisyenlerin serviks kanserine ilişkin bilgi düzeyleri. Kafkas Tıp Bilimleri Derg. 2016;6(3):175-180.
  • Nayar R, Wilbur DC. The Pap test and Bethesda 2014 classification system. Cancer Cytopathol. 2015;123(5):271-281. doi:10.1002/cncy.21521
  • Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP Risk-based management guidelines. J Low Genit Tract Dis. 2020;24(4):427-434. doi: 10.1097/LGT.0000000000000525
  • Hoorry T, Monie A, Gravitt P, Wu TC. Molecular epidemiology of human papillomavirus. J Formos Med Assoc. 2008;107:198-217. doi:10. 1016/S0929-6646(08)60138-7
  • Benedet JL, Matisic JP, Bertrand MA. Analysis of 84,244 patients in the BC screening program. Gynecol Oncol. 2004;92:127-134. doi:10.1016/j.ygyno.2003.09.019
  • Clifford GM, Smith JS, Plummer M, Muñoz N, Franceschi S. HPV types in invasive cervical cancer worldwide. Br J Cancer. 2003;88:63-73. doi: 10.1038/sj.bjc.6600688
  • Walboomers JMM, Jacobs MV, Manos MM, et al. HPV is a necessary cause of invasive cervical cancer. J Pathol. 1999;189(1):12-19. doi:10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
  • Adcock R, Cuzick J, Hunt WC, McDonald RM, Wheeler CM. Role of HPV genotype and viral load. Cancer Epidemiol Biomarkers Prev. 2019; 28:1816-1824. doi:10.1158/1055-9965.EPI-18-1335
  • Luo Q, Li H, Liu Y, et al. HPV prevalence among women in China. BMC Infect Dis. 2023;23:667. doi:10.1186/s12879-023-08486-z
  • Schmitt M, Dondog B, Waterboer T, Pawlita M. Homogeneous amplification of genital HPV. J Clin Microbiol. 2013;51:1458-1464. doi: 10.1128/JCM.00025-13
  • Wentzensen N, Schiffman M, Dunn T, et al. Multiple HPV genotype infections andcarcinogenesis. Int J Cancer. 2009;125:21512158. doi:10. 1002/ijc.24596
  • Li M, Li P, Yang Y, Liu M, Zhang J. Prevalence of HPV infection among Chinese women. J Med Virol. 2019;91:473-481. doi:10.1002/jmv.25341
  • Alci A, Gorkem U, Ayas S, Togrul C. HPV genotype distribution in Turkish women. Med Bull Sisli Etfal Hosp. 2025;59(3):338-344.
  • Salazar KL, Zhou HS, Xu J, et al. Multiple HPV infections and high-risk lesions. Acta Cytol. 2015;59(5):391-398. doi:10.1159/000439444
  • Herrero R. HPV vaccines: limited cross-protection. J Infect Dis. 2009; 199:919-922. doi:10.1086/597043
  • Fife KH, Cramer HM, Schroeder JM, Brown DR. The detection of multiple HPV types correlates with dysplasia. J Med Virol. 2001;64:550-559. doi:10.1002/jmv.1084
  • Kulhan M, Kulhan NG, Nayki C, Nayki U, Atağ F, Ulug P. HPV genotype distribution and mRNA expression levels. Contemp Oncol (Pozn). 2017;21(3):218-223. doi:10.5114/wo.2017.68618
  • Zhou H, Mody DR, Schwartz MR, et al. HPV genotype distribution in Latino women. J Am Soc Cytopathol. 2014;4:42-48. doi:10.1016/j.jasc. 2014.10.004

The relationship of multiple HPV DNA positivity with colposcopic biopsy results

Year 2026, Volume: 9 Issue: 2, 365 - 369, 12.03.2026
https://izlik.org/JA83WG22ML

Abstract

Aims: This study aimed to investigate the association between multiple HPV DNA positivity and the presence of high-grade cervical intraepithelial lesions or cervical cancer.
Methods: The medical records of 164 patients who underwent colposcopic biopsy in the department of obstetrics and gynecology were retrospectively reviewed. PAP smear results (LGSIL, ASCUS, ASC-H), HPV test positivity, and HPV genotypes were evaluated. Based on colposcopic biopsy findings, patients were categorized into two groups: group I: negative, LSIL, koilocytosis, and CIN I; group II: HSIL, CIN II–III, and squamous cell carcinoma.
Results: No statistically significant association was found between the presence of multiple HPV genotypes, single HPV genotype positivity, and colposcopic biopsy outcomes. Additionally, demographic factors such as age, parity, and menstrual status were not associated with high-grade cervical lesion development.
Conclusion: The present study does not provide evidence that multiple HPV infections increase the risk of cervical dysplasia or cervical cancer. Larger, prospective studies are needed to better clarify the clinical impact of multiple HPV infections.

Ethical Statement

Ethical approval for the study was obtained under project number 2017-597 on 17.08.2017.

Supporting Institution

This study received no financial support from any institution.

Project Number

2017-597

Thanks

The authors would like to thank all clinical staff who supported data collection during the study process. Portions of the manuscript benefited from the use of artificial intelligence–based tools solely for improving language clarity, grammar, and consistency; all scientific content, data interpretation, and conclusions were fully authored and approved by the researchers.

References

  • Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Glob Health. 2020;8:e191-203. doi:10.1016/S2214-109X(19)30482-6
  • Bruni L, Albero G, Serrano B, et al. Human Papillomavirus and Related Diseases in the World. Summary Report 2023. Institut Català d’Oncologia. 2023.
  • Markowitz LE, Dunne EF, Saraiya M, et al. Human papillomavirus vaccination: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Recomm Rep. 2014;63(RR-05):1-30.
  • Arbyn M, Sasieni P, Meijer C, Clavel C, Koliopoulos G, Dillner J. Clinical applications of HPV testing: a summary of meta-analyses. Vaccine. 2006;24(Suppl 3):S3/78-89. doi:10.1016/j.vaccine.2006.05.115
  • Trottier H, Mahmud S, Costa MC, et al. Human papillomavirus infections with multiple types and risk of cervical neoplasia. Cancer Epidemiol Biomarkers Prev. 2006;15(7):1274-1280. doi:10.1158/1055-9965.EPI-06-0129
  • ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and Related Cancer. Fact Sheet 2023. Institut Català d’Oncologia, Barcelona, Spain. 2023.
  • Dursun P, Ayhan A, Mutlu L, Güngör M, Haberal A. Servikal kanser öncülü lezyonlarda HPV tip dağılımı. Turk Patoloji Derg. 2013;29:210-216. doi:10.5146/tjpath.2013.01178
  • Bruno MT, Scalia G, Cassaro N, Boemi S. Multiple HPV 16 infection with two strains: a possible neoplastic progression marker. BMC Cancer. 2020;20(1):444. doi:10.1186/s12885-020-06916-9
  • Muñoz N, Bosch FX, de Sanjosé S, et al. Epidemiological classification of human papillomavirus types associated with cervical cancer. N Engl J Med. 2003;348(6):518-527. doi:10.1056/NEJMoa021641
  • Paavonen J, Naud P, Salmerón J, et al. Efficacy of HPV-16/18 AS04-adjuvanted vaccine (PATRICIA). Lancet. 2009;374:301-314. doi:10.1016/S0140-6736(09)61248-4
  • Karabulutlu Ö, Pasinlioğlu T. Alanı sağlıkla ilgili olmayan akademisyenlerin serviks kanserine ilişkin bilgi düzeyleri. Kafkas Tıp Bilimleri Derg. 2016;6(3):175-180.
  • Nayar R, Wilbur DC. The Pap test and Bethesda 2014 classification system. Cancer Cytopathol. 2015;123(5):271-281. doi:10.1002/cncy.21521
  • Perkins RB, Guido RS, Castle PE, et al. 2019 ASCCP Risk-based management guidelines. J Low Genit Tract Dis. 2020;24(4):427-434. doi: 10.1097/LGT.0000000000000525
  • Hoorry T, Monie A, Gravitt P, Wu TC. Molecular epidemiology of human papillomavirus. J Formos Med Assoc. 2008;107:198-217. doi:10. 1016/S0929-6646(08)60138-7
  • Benedet JL, Matisic JP, Bertrand MA. Analysis of 84,244 patients in the BC screening program. Gynecol Oncol. 2004;92:127-134. doi:10.1016/j.ygyno.2003.09.019
  • Clifford GM, Smith JS, Plummer M, Muñoz N, Franceschi S. HPV types in invasive cervical cancer worldwide. Br J Cancer. 2003;88:63-73. doi: 10.1038/sj.bjc.6600688
  • Walboomers JMM, Jacobs MV, Manos MM, et al. HPV is a necessary cause of invasive cervical cancer. J Pathol. 1999;189(1):12-19. doi:10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
  • Adcock R, Cuzick J, Hunt WC, McDonald RM, Wheeler CM. Role of HPV genotype and viral load. Cancer Epidemiol Biomarkers Prev. 2019; 28:1816-1824. doi:10.1158/1055-9965.EPI-18-1335
  • Luo Q, Li H, Liu Y, et al. HPV prevalence among women in China. BMC Infect Dis. 2023;23:667. doi:10.1186/s12879-023-08486-z
  • Schmitt M, Dondog B, Waterboer T, Pawlita M. Homogeneous amplification of genital HPV. J Clin Microbiol. 2013;51:1458-1464. doi: 10.1128/JCM.00025-13
  • Wentzensen N, Schiffman M, Dunn T, et al. Multiple HPV genotype infections andcarcinogenesis. Int J Cancer. 2009;125:21512158. doi:10. 1002/ijc.24596
  • Li M, Li P, Yang Y, Liu M, Zhang J. Prevalence of HPV infection among Chinese women. J Med Virol. 2019;91:473-481. doi:10.1002/jmv.25341
  • Alci A, Gorkem U, Ayas S, Togrul C. HPV genotype distribution in Turkish women. Med Bull Sisli Etfal Hosp. 2025;59(3):338-344.
  • Salazar KL, Zhou HS, Xu J, et al. Multiple HPV infections and high-risk lesions. Acta Cytol. 2015;59(5):391-398. doi:10.1159/000439444
  • Herrero R. HPV vaccines: limited cross-protection. J Infect Dis. 2009; 199:919-922. doi:10.1086/597043
  • Fife KH, Cramer HM, Schroeder JM, Brown DR. The detection of multiple HPV types correlates with dysplasia. J Med Virol. 2001;64:550-559. doi:10.1002/jmv.1084
  • Kulhan M, Kulhan NG, Nayki C, Nayki U, Atağ F, Ulug P. HPV genotype distribution and mRNA expression levels. Contemp Oncol (Pozn). 2017;21(3):218-223. doi:10.5114/wo.2017.68618
  • Zhou H, Mody DR, Schwartz MR, et al. HPV genotype distribution in Latino women. J Am Soc Cytopathol. 2014;4:42-48. doi:10.1016/j.jasc. 2014.10.004
There are 28 citations in total.

Details

Primary Language English
Subjects Gynecologic Oncology Surgery
Journal Section Research Article
Authors

Dilek Buldum 0000-0001-6328-1055

Şefik Eser Özyürek 0000-0002-5373-3991

Önder Aydın 0000-0000-1587-6283

Nurşen Kurtoğlu 0000-0002-8609-4487

Project Number 2017-597
Submission Date December 11, 2025
Acceptance Date January 29, 2026
Publication Date March 12, 2026
IZ https://izlik.org/JA83WG22ML
Published in Issue Year 2026 Volume: 9 Issue: 2

Cite

AMA 1.Buldum D, Özyürek ŞE, Aydın Ö, Kurtoğlu N. The relationship of multiple HPV DNA positivity with colposcopic biopsy results. J Health Sci Med / JHSM. 2026;9(2):365-369. https://izlik.org/JA83WG22ML

Interuniversity Board (UAK) Equivalency: Article published in Ulakbim TR Index journal [10 POINTS], and Article published in other (excuding 1a, b, c) international indexed journal (1d) [5 POINTS].

The Directories (indexes) and Platforms we are included in are at the bottom of the page.

Note: Our journal is not WOS indexed and therefore is not classified as Q.

You can download Council of Higher Education (CoHG) [Yüksek Öğretim Kurumu (YÖK)] Criteria) decisions about predatory/questionable journals and the author's clarification text and journal charge policy from your browser. https://dergipark.org.tr/tr/journal/2316/file/4905/show







The indexes of the journal are ULAKBİM TR Dizin, ICI World of Journals, DOAJ, Directory of Research Journals Indexing (DRJI), General Impact Factor, ASOS Index, WorldCat (OCLC), MIAR, OpenAIRE, Türkiye Citation Index, Türk Medline Index, InfoBase Index, Scilit, etc.

       images?q=tbn:ANd9GcRB9r6zRLDl0Pz7om2DQkiTQXqDtuq64Eb1Qg&usqp=CAU

500px-WorldCat_logo.svg.png

atifdizini.png

logo_world_of_journals_no_margin.png

images?q=tbn%3AANd9GcTNpvUjQ4Ffc6uQBqMQrqYMR53c7bRqD9rohCINkko0Y1a_hPSn&usqp=CAU

doaj.png  

images?q=tbn:ANd9GcSpOQFsFv3RdX0lIQJC3SwkFIA-CceHin_ujli_JrqBy3A32A_Tx_oMoIZn96EcrpLwTQg&usqp=CAU

ici2.png

asos-index.png

drji.png





The platforms of the journal are Google Scholar, CrossRef (DOI), ResearchBib, Open Access, COPE, ICMJE, NCBI, ORCID, Creative Commons, etc.

COPE-logo-300x199.jpgimages?q=tbn:ANd9GcQR6_qdgvxMP9owgnYzJ1M6CS_XzR_d7orTjA&usqp=CAU

icmje_1_orig.png

cc.logo.large.png

ncbi.pngimages?q=tbn:ANd9GcRBcJw8ia8S9TI4Fun5vj3HPzEcEKIvF_jtnw&usqp=CAU

ORCID_logo.png

1*mvsP194Golg0Dmo2rjJ-oQ.jpeg


Our Journal using the DergiPark system indexed are;

Ulakbim TR Dizin,  Index Copernicus, ICI World of JournalsDirectory of Research Journals Indexing (DRJI), General Impact FactorASOS Index, OpenAIRE, MIAR,  EuroPub, WorldCat (OCLC)DOAJ,  Türkiye Citation Index, Türk Medline Index, InfoBase Index


Our Journal using the DergiPark system platforms are;

Google, Google Scholar, CrossRef (DOI), ResearchBib, ICJME, COPE, NCBI, ORCID, Creative Commons, Open Access, and etc.


Journal articles are evaluated as "Double-Blind Peer Review". 

Our journal has adopted the Open Access Policy and articles in JHSM are Open Access and fully comply with Open Access instructions. All articles in the system can be accessed and read without a journal user.  https//dergipark.org.tr/tr/pub/jhsm/page/9535

Journal charge policy   https://dergipark.org.tr/tr/pub/jhsm/page/10912

Our journal has been indexed in DOAJ as of May 18, 2020.

Our journal has been indexed in TR-Dizin as of March 12, 2021.


17873

Articles published in Journal of Health Sciences and Medicine have open access and are licensed under the Creative Commons CC BY-NC-ND 4.0 International License.