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Human Papilloma Virus Genotype
Distribution in Women With Cervical
İntraepithelial Neoplasia
Mehmet Bülbül1, Berna Dilbaz1, Bilge Aydın Aktürk2, Filiz Hatipoğlu1,
Esra Boyar1
1Adıyaman
University Faculty of Medicine, Department of Obstetrics and Gynecology, Adıyaman
2 Adıyaman
University Faculty of Medicine, Department of Medical Pathology, Adıyaman
Introduction
• HPV group causes widespread infection worldwide.
• Out of 100 genotypes of HPV around 13 are linked with cancers.
• Of the sexually transmitted 40 HPV genotypes, high-risk strains are
mainly HPV16, 18 that cause most of the cervical cancer cases.
• Other high-risk strains are 31, 33, 45, 52, 58.
• However there are regional differences about the prevalence of
different HPV genotypes.
• The aim of this study is to investigate the prevalance of HPV
genotypes in patients with cervical intraepithelial neoplasia confirmed
by colposcopy-guided biopsies.
Material and Method
• Adıyaman University Training and Research Hospital Colposcopy
Clinic
• Between April 2015 and March 2017.
Colposcopy + Bx
N: 128
HPV positive
(N=31, 24,2%)
Abnormal
cervical smear
(N=27, 21,1%)
Both
(N=70, 54,7%)
• The pathological findings of the patients with abnormal smear results
were as follows:
•
•
•
•
•
ASCUS (N=46),
ASC-H (N=8),
LGSIL (N=36),
High grade SIL (N=3),
Atypical glandular cell (N=3).
• Cervical pathologies were confirmed with colposcopy guidedbiopsies.
• Colposcopy-guided biopsies:
• 63 patients bening or infectious.
• 55 patients CIN 1 – CIN 2-3
Findings
Mean±SD
Age
41.6±9.6
Gravida
4,6±2,5
Age of first intercourse
19.9±4.6
• Out of the 55 patients one patient who was diagnosed to have HG-SIL
with cervical smear, was diagnosed to have cervical carcinoma after
histopathological analysis of the biopsy specimen taken during
colposcopy.
• 54 patients
• 29 patients CIN1 and
• 25 patients CIN2-3
• The most frequently encountered HPV genotype was HPV 16 (42.1%)
Table 1: The distribution of HPV genotypes in the patient group
HPV 6
HPV 16 HPV 18 HPV 31 HPV 35 HPV 39 HPV 40 HPV 42 HPV 44 HPV 45 HPV 51 HPV 53 HPV 56 HPV 58 HPV 59 HPV 66 HPV 68 HPV 69 HPV 70
1 (1,9)
8 (14,8) 1 (1,9)
2 (3,7)
1 (1,9)
4 (7,4)
2 (3,7)
1 (1,9)
1 (1,9)
1 (1,9)
3 (5,6)
3 (5,6)
2 (3,7)
0 (0,0)
1 (1,9)
4 (7,4)
2 (3,7)
1 (1,9)
0 (0,0)
CIN II0 (0,0)
III
15
(27,8)
3 (5,6)
1 (1,9)
1 (1,9)
0 (0,0)
0 (0,0)
2 (3,7)
1 (1,9)
3 (5,6)
4 (7,4)
1 (1,9)
1 (1,9)
3 (5,6)
3 (5,6)
0 (0,0)
0 (0,0)
0 (0,0)
1 (1,9)
Total
N: 54
23
(42,6)
4 (7,4)
3 (5,6)
2 (3,7)
4 (7,4)
2 (3,7)
3 (5,6)
2 (3,7)
4 (7,4)
7 (12,9) 4 (7,4)
3 (5,6)
3 (5,6)
4 (7,4)
4 (7,4)
2 (3,7)
1 (1,9)
1 (1,9)
CIN I
1 (1,9)
• Only one HPV genotype was found in 22 (75.9%) of the patients with
CIN I while the remaining had more then one HPV genotype. Out of
the 25 patients whose final diagnosis was CIN 2-3, 15 had one HPV
genotype (60.0%) while the remaining had at least two HPV
genotypes.
Table 2: The presence of HPV genotypes in cervical intraepithelial neoplasias
HPV genotypes present
1
>=2
Total
CIN I (N=29)
22 (75,9)
7 (24,1)
29 (100)
CIN II-III (N=25)
15 (60,0)
10 (40,0)
25 (100)
Total
27
17
54
Discussion
• As cervical cancer is the one of the leading cause of cancer-related deaths among
women worldwide, it is very important to have a nation-wide screening
programme for cervical cancer.
• Previous studies from Turkey reported a prevalence rate of HPV ranging from
1.4% to 26% and the most common HPV types in cytologically abnormal women
were HPV 16, HPV 16 and HPV18.
• Dursun et al reported multiple HPV infection rate in women with normal Pap test
as 2.2%.
• In the presented study multiple infection rate was 35% in patients with
hispotahologically confirmed cervical intraepithelial neoplasia (CIN1,2-3).
• The presented study points out the importance of colposcopy and colposcopyguided biopsy in women with abnormal smear or positive HPV testing.
References
1.
Tuncer ZS, Basaran M, Ustaçelebi S, Kuzey GM. High-Risk Human Papilloma Virus (HPV)
Infection Determined By Hybrid Capture II Assay in a Turkish University Hospital Outpatient
Clinic MN-Gorm. 2006. pp. 129–134.
2.
Ozçelik B, Serin IS, Gökahmetoğlu S, Başbuğ M, Erez R. Human papillomavirus frequency of
women at low risk of developing cervical cancer: a preliminary study from a Turkish university
hospital. Eur J Gynaecol Oncol. 2003;24(2):157–9. [PubMed]
3.
Seçkin S, Aksoy F, Yıldırım M. Servikal Smearlerde HPV İnfeksiyonu Görülme İndisansı
Ankara Numune Eğitim ve Araştırma Hastanesi Tıp Dergisi. 1996;36(1-2-3-4):101–103.
4.
Safi Z, Demirezen S, Beksaç MS, Kuzey GM, Kocagöz T, Ustaçelebi Ş, Hasçelik G, Çakar An.
İnsan Papilloma Virusunun (IPV) Polimeraz Zincir Reaksiyonu Tekniği İle Servikal Ve Vajinal
Akıntı Örneklerinde Saptanması Mn-Klinik Bilimler&Doktor. 2002;8(1):112–114
5.
Dursun P, Senger SS, Arslan H, Kuşçu E, Ayhan A. Human papillomavirus (HPV) prevalence
and types among Turkish women at a gynecology outpatient unit. BMC Infect Dis. 2009; 9: 191
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