Human papillomavirus genotyping in low-grade squamous intraepithelial lesions
, 13, 4, 4, 4, 4, 15
Abstract
Objectives: Human papillomavirus infection is one of the most common sexually transmitted infections. Histological LSIL in 70–80% of cases will regress spontaneously, while a subset is associated with residual risk for a future precancerous lesion. This study evaluates the performance of HPV genotypes for LSIL preceded by normal or mildly abnormal Pap smear. Material and methods: We provide a prospective observational cohort study. We obtained material from 428 women registered to Specialist Medical Practice and Provincial Hospital in Poznań in 2018–2021. In the current study, we analyze results from the first 112 inclusions with the diagnosis of LSIL from a cervical biopsy. The probe for the molecular test was collected with a combi brush and passed to the independent, standardized laboratory. HPV detection was done using PCR followed by DNA enzyme immunoassay and genotyping with a reverse hybridization line probe assay. Sequence analysis was performed to characterize HPV — positive samples with unknown HPV genotypes. The molecular test detected DNA of 42 HPV genotypes. We performed statistical analyzes using the STATISTICA package 13.3. Results: We found that 77.7% of patients received HPV-positive test results. The most frequent HPV genotype was 16, which was assumed for 22.3%. We detected that following HPV types are next most common: HPV 56 (11.6%), HPV 52 (8.9%), HPV 31 (8.0%) and HPV 51 (8.0%). Among HPV 16-negative women, the vast majority are those living in the town (p = 0.048). Moreover, thyroid diseases were the most common comorbidities. Conclusions: To our knowledge, this study is the most extensive assessment of HPV genotypes in LSIL diagnoses in Poland.
Keywords: HPV genotypingLSILlow-grade lesioncervix biopsy
References
- Schiffman M, Doorbar J, Wentzensen N, et al. Carcinogenic human papillomavirus infection. Nat Rev Dis Primers. 2016; 2: 16086.
- Rodríguez AC, Schiffman M, Herrero R, et al. Proyecto Epidemiológico Guanacaste Group. Rapid clearance of human papillomavirus and implications for clinical focus on persistent infections. J Natl Cancer Inst. 2008; 100(7): 513–517.
- World Health Organisation. INTERNATIONAL AGENCY FOR RESEARCH ON CANCER IARC Monographs on the Evaluation of Carcinogenic Risks to Humans VOLUME 90 Human Papillomaviruses. Human Papillomaviruses. 2007; 90.
- IARC. Biological agents volume 100 B A review of human carcinogens: IARC monographs evaluate carcinogenic risks to humans. IARC Monographs. 2012; 100.
- Dijkstra MG, Snijders PJF, Arbyn M, et al. Cervical cancer screening: on the way to a shift from cytology to full molecular screening. Ann Oncol. 2014; 25(5): 927–935.
- Rees I, Jones D, Chen H, et al. Interventions to improve the uptake of cervical cancer screening among lower socioeconomic groups: A systematic review. Prev Med. 2018; 111: 323–335.
- Saslow D, Solomon D, Lawson HW, et al. American Cancer Society, American Society for Colposcopy and Cervical Pathology, American Society for Clinical Pathology. American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology screening guidelines for the prevention and early detection of cervical cancer. Am J Clin Pathol. 2012; 137(4): 516–542.
- Karsa Lv, Arbyn M, Vuyst HDe, et al. European guidelines for quality assurance in cervical cancer screening. Summary of the supplements on HPV screening and vaccination. Papillomavirus Research. 2015; 1: 22–31.
- Arbyn M, Buntinx F, Van Ranst M, et al. Virologic versus cytologic triage of women with equivocal Pap smears: a meta-analysis of the accuracy to detect high-grade intraepithelial neoplasia. J Natl Cancer Inst. 2004; 96(4): 280–293.
- Arbyn M, Ronco G, Anttila A, et al. Evidence regarding human papillomavirus testing in secondary prevention of cervical cancer. Vaccine. 2012; 30 Suppl 5: F88–F99.
- Money D, Roy M, Scrivener J, et al. Canadian Consensus Guidelines on Human Papillomavirus. Journal of Obstetrics and Gynaecology Canada. 2007; 29(8): S1.
- Arbyn M, Anttila A, Jordan J, et al. European Guidelines for Quality Assurance in Cervical Cancer Screening. Second edition--summary document. Ann Oncol. 2010; 21(3): 448–458.
- ASCUS-LSIL Traige Study (ALTS) Group. A randomized trial on the management of low-grade squamous intraepithelial lesion cytology interpretations. Am J Obstet Gynecol. 2003; 188(6): 1393–1400.
- Zuna RE, Wang SS, Rosenthal DL, et al. ALTS Group. Determinants of human papillomavirus-negative, low-grade squamous intraepithelial lesions in the atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesions triage study (ALTS). Cancer. 2005; 105(5): 253–262.
- Arbyn M, Roelens J, Simoens C, et al. Human papillomavirus testing versus repeat cytology for triage of minor cytological cervical lesions. Cochrane Database Syst Rev. 2013(3): CD008054.
- Rogstad KE. The psychological impact of abnormal cytology and colposcopy. BJOG. 2002; 109(4): 364–368.
- McCredie MRE, Sharples KJ, Paul C, et al. Natural history of cervical neoplasia and risk of invasive cancer in women with cervical intraepithelial neoplasia 3: a retrospective cohort study. Lancet Oncol. 2008; 9(5): 425–434.
- Pruski D, Fraszczak J, Iwaniec K, et al. Assessment of frequency of regression and progression of mild cervical neoplasia--LGSIL in women with positive high-risk HPV DNA test result. Ginekol Pol. 2012; 83(8): 572–575.
- Bosch FX, de Sanjosé S. Chapter 1: Human papillomavirus and cervical cancer--burden and assessment of causality. J Natl Cancer Inst Monogr. 2003(31): 3–13.
- Schlecht NF, Platt RW, Duarte-Franco E, et al. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. J Natl Cancer Inst. 2003; 95(17): 1336–1343.
- Franco EL. Chapter 13: Primary screening of cervical cancer with human papillomavirus tests. J Natl Cancer Inst Monogr. 2003(31): 89–96.
- Solomon D. Chapter 14: Role of triage testing in cervical cancer screening. J Natl Cancer Inst Monogr. 2003(31): 97–101.
- Galloway DA. Papillomavirus vaccines in clinical trials. Lancet Infect Dis. 2003; 3(8): 469–475.
- Muñoz N. Human papillomavirus and cancer: the epidemiological evidence. J Clin Virol. 2000; 19(1-2): 1–5.
- 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.
- Clifford GM, Smith JS, Aguado T, et al. Comparison of HPV type distribution in high-grade cervical lesions and cervical cancer: a meta-analysis. Br J Cancer. 2003; 89(1): 101–105.
