Determination of HPV by PCR and immunohistochemistry in cervival invasive squamous cell carcinoma

Öz

Many epidemiological, clinicopaihological and molecular studies have shown the role of human papilloma virus (HPV) in the pathogenesis of the cervical carcinoma precursor lesions. Polimerase chain reaction (PCR), is very sensitive method for its establishment. Another method to identify HPV in cervival samples is immunohistochemistry (IHC). In this study, we aimed to determine HPV incidence in cervical invasive squamous cell carcinoma (ISCC) by using PCR and IHC and to investigate the correlation between HPV types and histological types. In our pathology department, 26 cases are investigated for HPV presence and types by PCR method. They are evaluated for HPV presence immunohistochemically by BSA-peroxidase (DAB) method. By PCR we found HPV 16 in 23%, 18 in 11.5%, 33 in 4%, 16+33 (mixt infection) in 4% of the cases. We didn't show HPV 6 and 11 in any of the cases. HPV positivity was 30.5%, immunohistochemically. In 5 of the 15 cases that were found to be negative by PCR, HPV was shown by IHC. The percentage of the cases proven to be HPV positive by PCR and/or IHC was 61.5%. When we compared the histological types with HPV types established by PCR, 18% of large cell keratinizing carcinoma (LCKC) was HPV 16 (+), 18% was 18 (+), 9% was 33 (+), 9% was 16+33 (+) and 46% was HPV(-); whereas 13% of large cell non-keratinizing carcinoma (LCNKC) was HPV 16(+), 18% was 18 (+), 69% was HPV(-) and 50% of small cell carcinoma was HPV 16(+), 50% was HPV(-). When we evaluated the histological type distribution oflHC-proven HPV positive cases, 37.5% was LCKC and 62.5% was LCNKC. We find the role and incidence of HPV in cervical carcinoma cases in our country comparable to global evidence; we conclude with the importance of screening programmes.

Anahtar Kelimeler

• Cervix Uteri,Uterine Cervical Neoplasms,Human papillomavirus 6,Human papillomavirus 16,Human papillomavirus 18,Human papillomavirus 11,Immunohistochemistry,Carcinoma, Squamous Cell

Serviksin invaziv skuamöz hücreli karsinomlarında HPV'nin PCR ve immünohistokimyasal yöntemlerle belirlenmesi

Öz

Birçok epidemiyolojik klinikopatolojik ve moleküler çalışmalar çoğu servikal kanser prekürsör lejyonlarının patogenezinde human papilloma virüsün (HPV) varlığını ortaya koymuştur. Moleküler biyolojik tekniklerden polimeraz zincir reaksiyonu (PCR) oldukça duyarlı bir yöntemdir. Servikse ait örneklerde HPV yi belirlemede kullanılan bir başka yöntem de immünohistokimyasal (İHK) yöntemdir. Çalışmamızda serviksin invaziv skuamöz hücreli karsinomlarmda (İSHK), PCR ve İHK yöntemi kullanarak HPV insidansını belirlemekve bulunan HPV tipleri ile histolojik tip arasındaki korelasyonu incelemeyi amaçladık. Kliniğimizde İSHK tanısı almış 26 vaka PCR yöntemiyle hem HPV varlığı hem de HPV tipleri açısından; ayrıca İHK olarak HPV varlığı yönünden BSA-peroksidaz (DAB) yöntemiyle incelendi. Olgularımızda PCR yöntemiyle HPV 16 yi %23, HPV18'i %U.5, HPV33'ü % 4, HPV16+33'ü (mikst enfeksiyon) %4 oranında belirledik. HPV 6 ve IVi hiçbir olguda tespit etmedik. 26 olgumuzda İHK yöntemle % 30.5 oranında HPV pozitivitesi saptadık. PCR ile (-) bulduğumuz 15 olgudan 5'inde İHK ile HPV tespit ettik. PCR ve/veya İHK yöntemiyle HPV pozitivitesi saptadığımız olguların oranı %61.5' di. Histolojik tipleri PCR yöntemi ile bulduğumuz HPV tipleri ile karşılaştırdığımızda büyük hücreli keratinize karsinomların (BHKK) % 18'ni HPV 16 (+), % 18'ni HPV 18 (+), % 9 'nu HPV33 (+), %9'nu HPV 16+33 (+), % 46'sını HPV(-) tespit ettik. Büyük hücreli nonkeratinize karsinomların (BHNKK) % 13'üHPV16(+), %18' i HPV 18 (+), % 69'u HPV(-); küçük hücreli karsinomların (KHK) % 50'si HPV16(+), % 50'si HPV(-) di. İHK olarak pozitif olguların histolojik tip dağılımını incelediğimizde % 37.5'ni BHKK %62.5'ni BHNKK olarak belirledik. Yaptığımız çalışmada servikal karsinomlarda HPV'nin rolü ve insidansının dünya çapındaki bulgularla kesin benzerlikler gösterdiğini ve tarama programlarının önemini vurgulamaya çalıştık.

Anahtar Kelimeler

• Serviks uteri,Uterin servikal neoplazmlar,İnsan papillomavirüs 6,İnsan papillomavirüs 16,İnsan papillomavirüs 18,İnsan papillomavirüs 11,İmmünohistokimya,Karsinom, yassı hücreli

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