Endocervical polyps in high risk human papillomavirus infections
Abstract
Objectives: Human papillomavirus (HPV) positive patients with and without endocervical polyps is compared with respect to HPV genotypes and presence of pre-invasive diseases. To our knowledge, this is the first and largest report in the literature examining the endocervical polyps in HPV positive cases.
Material and methods: Clinicopathological data for the first one million screening patients (n = 1 060 992) from around the entire country during 2015 and 2016 were targeted for this research. Colposcopy, colposcopic surgical diagnostic procedures and final pathology results of 3499 patients with high-risk (HR) HPV-positive were obtained from reference colposcopy centers. Patients with endocervical polyps (n = 243 [6.9 %]) were accepted as experimental arm while patients without any endocervical polyp (n = 3256 [93.1%]) were regarded as the control group. Age, HPV genotype, Pap smear abnormality, and final pathological results were compared between two groups using Student’s t-test and cross-tabulation chi-square test.
Results: The incidence of endocervical polyp was found to be 6.9 % in HR HPV-positive women. The most common HPV genotypes observed in both groups were HPV 16 or 18. Abnormal cytology reports (≥ ASC-US) were not significantly different between both groups. However, with respect to final pathological diagnosis, patients with endocervical polyp had significantly lower numbers of pre-invasive diseases (31.3% vs 44.2%; p < 0.10).
Conclusions: Endocervical polyps may be more common in patients with HR HPV infections. HPV 18 is observed significantly more, in the HR HPV positive endocervical polyp group. Patients with endocervical polyps do not have increased risk for preinvasive cervical diseases.
Keywords: cervical cancercolposcopyhuman papillomavirusendocervical polypHPV 18cervical cancer screening
References
- Aaro LA, Jacobson LJ, Soule EH. Endocervical polyps. Obstet Gynecol. 1963; 21: 659–665.
- Berzolla CE, Schnatz PF, O'Sullivan DM, et al. Dysplasia and malignancy in endocervical polyps. J Womens Health (Larchmt). 2007; 16(9): 1317–1321.
- Schnatz PF, Ricci S, O'Sullivan DM. Cervical polyps in postmenopausal women: is there a difference in risk? Menopause. 2009; 16(3): 524–528.
- Korucuoglu U, Guler I, Dogan H, et al. Human papillomavirus effect on the development of endometrial polyps. Eur J Gynaecol Oncol. 2015; 36(5): 551–553.
- Andersson S, Rylander E, Larsson B, et al. The role of human papillomavirus in cervical adenocarcinoma carcinogenesis. Eur J Cancer. 2001; 37(2): 246–250.
- Castellsagué X, Díaz M, de Sanjosé S, et al. International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Worldwide human papillomavirus etiology of cervical adenocarcinoma and its cofactors: implications for screening and prevention. J Natl Cancer Inst. 2006; 98(5): 303–315.
- Goldshmid O, Schejter E, Kugler D, et al. Is removal of asymptomatic cervical polyps necessary?: histologic findings in asymptomatic Israeli Jewish women. J Low Genit Tract Dis. 2011; 15(4): 259–262.
- Chin N, Platt AB, Nuovo GJ. Squamous intraepithelial lesions arising in benign endocervical polyps: a report of 9 cases with correlation to the Pap smears, HPV analysis, and immunoprofile. Int J Gynecol Pathol. 2008; 27(4): 582–590.
- Crum CP, Lee KR. Diagnostic Gynecologic and Obstetric Pathology. Elsevier Saunders, Philadelphia 2005: 419–20.
- Younis MTS, Iram S, Anwar B, et al. Women with asymptomatic cervical polyps may not need to see a gynaecologist or have them removed: an observational retrospective study of 1126 cases. Eur J Obstet Gynecol Reprod Biol. 2010; 150(2): 190–194.
- MacKenzie IZ, Naish C, Rees CMP, et al. Why remove all cervical polyps and examine them histologically? BJOG. 2009; 116(8): 1127–1129.
