1
|
Liu Q, Zhang T, Chen L, Zhou X, Zhang X, Zheng W, Niu S, Zhou F. Correlation of immediate prevalence of cervical precancers and cancers with HPV genotype and age in women with ASC-US/hrHPV+: a retrospective analysis of 2292 cases. J Clin Pathol 2024; 77:338-342. [PMID: 36653168 DOI: 10.1136/jcp-2022-208580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023]
Abstract
AIMS To stratify the risk of cervical precancers (high-grade squamous intraepithelial lesion (HSIL) and adenocarcinoma in situ (AIS)) and cancers (squamous cell carcinoma (SCC) and adenocarcinoma) based on distinct high-risk human papillomavirus (hrHPV) genotypes as well as age groups among women with atypical squamous cells of undetermined significance (ASC-US) and hrHPV+results. METHODS In total, 2292 cases of ASC-US/hrHPV+ with immediate follow-up biopsy results were included in the study for prevalence analysis. RESULTS Overall, 12.2% women with ASC-US /hrHPV+ had HSIL+ while 0.22% had AIS+ lesions. The HPV-16+ group (31.6%) showed significantly higher prevalence of HSIL+ squamous lesions than other genotype groups (p<0.0001). The prevalence of SCC is significantly higher in HPV-16+ (1.8%) or HPV-18/45+ (1.1%) group than women in other genotype groups (0.1%) (p<0.0001). The HPV-18/45+ group (1.7%) showed significantly higher prevalence of AIS+ glandular lesions than other genotype groups (p=0.003). In addition, SCC prevalence was significantly higher in age over 50 group than that in age under 50 group (1.2% vs 0.2%, p=0.012). CONCLUSION Women with ASC-US/hrHPV+ are at significant risk of cervical precancers and cancers; notably, HPV-16+ group has a higher risk of HSIL squamous lesions and SCC while HPV-18/45+ group has a higher risk of AIS+ glandular lesions. In addition, the older patient group (>50 years) has a significantly higher risk of SCC. Therefore, HPV genotyping as well as patient age need to be considered in the clinical management of patient.
Collapse
Affiliation(s)
- Qin Liu
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Tao Zhang
- Department of Gynecology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Liqing Chen
- Department of Gynecology, Zhejiang University School of Medicine Women's Hospital, Hangzhou, Zhejiang, China
| | - Xin Zhou
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Xiaofei Zhang
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| | - Wenxin Zheng
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pathology, Parkland Hospital, Dallas, Texas, USA
| | - Shuang Niu
- Department of Pathology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
- Department of Pathology, Parkland Hospital, Dallas, Texas, USA
| | - Feng Zhou
- Department of Pathology, Zhejiang University School of Medicine Women'sHospital, Hangzhou, Zhejiang, China
| |
Collapse
|
2
|
Ittiamornlert P, Jareemit N, Phianpiset R, Kuljarusnont S, Hanamornroongruang S, Horthongkham N, Khajorndumrongcherdkul P, Ruengkhachorn I. High-risk human papillomavirus genotyping in women with atypical squamous cells of undetermined significance. Sci Rep 2023; 13:12134. [PMID: 37495771 PMCID: PMC10372087 DOI: 10.1038/s41598-023-39206-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 07/21/2023] [Indexed: 07/28/2023] Open
Abstract
We conducted a prospective study to evaluate the prevalence of high-risk human papillomavirus (hr-HPV) positivity in women with atypical squamous cells of undetermined significance (ASC-US). Additionally, we assessed the association of hr-HPV positivity with the pathology of high-grade squamous intraepithelial lesions or worse (HSIL+) and the risk of subsequent detection of squamous intraepithelial lesions. A total of 376 women were included, with 242 (64.4%) exhibiting hr-HPV positivity. The predominant HPV genotypes were 16, 52 and 58. Factors associated with the immediate detection of HSIL+ pathology included a colposcopic impression of high-grade lesions, hr-HPV positivity, HPV 16 positivity, HPV 18 positivity, HPV 58 positivity, age less than 40 years, and biopsy of two or more pieces. However, only the first three factors were statistically significant in multivariate analysis. Among the 291 women who continued surveillance for 6 months or more, the median follow-up period was 41.8 months (interquartile range [IQR] 26.5-54.0). The prevalence of subsequent HSIL in women with hr-HPV positivity versus negativity was 3.6% versus 0.98%, respectively. The median time to the subsequent detection of SIL was 28.7 months (IQR 14.9-41.7). In conclusion, women with ASC-US in our study had a high proportion of hr-HPV positivity. Type-specific HPV testing could play a pivotal role in the development of specific management protocols for women with ASC-US.Clinical trial registration: https://thaiclinicaltrials.org , TCTR20161017002.
Collapse
Affiliation(s)
- Pornporm Ittiamornlert
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Nida Jareemit
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | - Rattiya Phianpiset
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sompop Kuljarusnont
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand
| | | | - Navin Horthongkham
- Department of Microbiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Pornnida Khajorndumrongcherdkul
- Division of Obstetrics and Gynaecological Nursing, Department of Nursing Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Irene Ruengkhachorn
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wanglang Road, Bangkoknoi, Bangkok, 10700, Thailand.
| |
Collapse
|
3
|
Safi Oz Z, Onak Kandemir N, Kokturk F, Ozdamar SO. Cytomorphometry and morphology analysis of human papillomavirus type 16 in liquid-based cervical cytology samples. Diagn Cytopathol 2021; 49:885-893. [PMID: 33904658 DOI: 10.1002/dc.24761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND Human papillomavirus (HPV) is the main causal factor of cervical carcinoma. HPV 16 is one of the most prominent oncogenic types. We aimed to evaluate the cytomorphometric and morphological alterations caused by HPV 16 in liquid-based cytology (LBC). METHODS The Cobas 4800 HPV system was used for the detecting and typing HPV DNA in cervical specimens. In this study, 30 HPV 16 positive and 30 HPV 16 negative cervical samples were evaluated for micronuclei (MN), nonclassical cytologic abnormalities, and the nuclear-to-cytoplasmic ratio. Nuclear and cellular areas were evaluated using image analysis software and the nuclear-to-cytoplasm ratio was calculated. All analyses were performed blinded to the patients' HPV status. Statistical evaluation was carried out using the χ2 and Fisher test; P-values < .05 were considered significant. RESULTS The frequencies of micronucleated cells and koilocytes were higher in the HPV 16 infected group (P < .05). Cells with perinuclear halo in control group were higher than the HPV 16 infected group (P < .05). The mean nuclear-to-cytoplasm ratio in HPV 16 patients was higher than the control value, but the difference was not statistically significant. CONCLUSION LBC can be used to detect morphological and morphometric changes. HPV 16 induces the formation of MN and koilocytosis. The evaluation of MN could provide additional information in monitoring genomic instability and of koilocytes could provide information about damage to the cytoskeleton filaments in HPV infection. Further studies are needed to investigate the effects of HPV-18 and other high-risk HPV types on the cell size and nucleus-to-cytoplasm ratio.
Collapse
Affiliation(s)
- Zehra Safi Oz
- Faculty of Medicine, Department of Medical Biology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Nilufer Onak Kandemir
- Faculty of Medicine, Department of Pathology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Furuzan Kokturk
- Faculty of Medicine, Department of Biostatistics, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| | - Sukru Oguz Ozdamar
- Faculty of Medicine, Department of Pathology, Zonguldak Bulent Ecevit University, Zonguldak, Turkey
| |
Collapse
|