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Soleimani-Jelodar R, Arashkia A, Shoja Z, Sharifian K, Akhavan S, Yarandi F, Jalilvand S. Type-specific human papillomavirus prevalence in women referred for colposcopy in Tehran. IRANIAN JOURNAL OF MICROBIOLOGY 2024; 16:421-427. [PMID: 39005605 PMCID: PMC11245344 DOI: 10.18502/ijm.v16i3.15799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
Background and Objectives Although several studies have been achieved on the frequency of the HPV types among women with cervical cancer in Iran, HPV-positive samples were in some cases directed to specific-primer genotyping of HPV 16 and 18. Therefore, the other HPV types are underestimated. Several studies have also reported a greater prevalence of HPV 16 in cervical cancer in Iran than in the world. To clarify these subjects, the distribution of HPV types in women referred for colposcopy in Tehran was investigated. Materials and Methods In this cross-sectional study, a total of 148 cervical samples from women with normal, atypical squamous cells of undetermined significance, cervical intraepithelial neoplasia I-III, and invasive cervical cancer histopathology were included. HPV was detected by PCR assay and all HPV-positive specimens were subjected to direct nucleotide sequencing. Results Our results demonstrated that the total prevalence of HPV was 92.5%. The five most common HPV types were HPV 16 (49.3%), 18 (14.8%), 6 (7.4%), 31 (4.1%), and 11 (2.7%). About the histopathological stage, HPV 16 and 18 were dominant in all studied groups. In cervical cancer, HPV 16 and 18 were detected in 60% and 20% of cases, respectively. Conclusion HPV 16 and 18 were the most common in cervical cancer in Iran.
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Affiliation(s)
- Rahim Soleimani-Jelodar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Arashkia
- Department of Virology, Pasteur Institute of Iran, Tehran, Iran
| | | | - Kimia Sharifian
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Setareh Akhavan
- Department of Gynecology Oncology, Imam Khomeini Hospital Complex, Valiasr Hospital Tehran, Iran
| | - Fariba Yarandi
- Department of Obstetrics and Gynecology, Yas Hospital, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Salavatiha Z, Farahmand M, Shoja Z, Jalilvand S. A meta-analysis of human papillomavirus prevalence and types among Iranian women with normal cervical cytology, premalignant lesions, and cervical cancer. J Med Virol 2021; 93:4647-4658. [PMID: 33694179 DOI: 10.1002/jmv.26928] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2020] [Revised: 01/23/2021] [Accepted: 02/01/2021] [Indexed: 01/09/2023]
Abstract
In this study, all data from Iran on human papillomavirus (HPV) prevalence and types among women with normal cervical cytology, premalignant lesions, and cervical cancer were obtained and pooled. The overall HPV prevalence was found to be 9% in women with a normal cervix, 55% in atypical squamous cells of undetermined significance or atypia cases, 58% and 69% in women with low and high grade squamous intraepithelial lesions, respectively, and 81% among women with invasive cervical cancer. In all of the studied groups, HPV 16 was the most common HPV type, followed by HPV 18. In conclusion, this meta-analysis revealed that it will be beneficial if current HPV vaccines are integrated into the national vaccination programs of Iran.
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Affiliation(s)
- Zahra Salavatiha
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Shoja Z, Farahmand M, Hosseini N, Jalilvand S. A Meta-Analysis on Human Papillomavirus Type Distribution among Women with Cervical Neoplasia in the WHO Eastern Mediterranean Region. Intervirology 2019; 62:101-111. [PMID: 31527382 DOI: 10.1159/000502824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 08/20/2019] [Indexed: 12/09/2022] Open
Abstract
INTRODUCTION To date, the human papillomavirus (HPV) vaccine has not been integrated into the national vaccination program of most countries of the WHO Eastern Mediterranean Region (EMRO), except for the United Arab Emirates and Libya. The knowledge of HPV genotype distribution in cervical neoplasia is valuable to predict the impact of current HPV vaccines on cancer prevention and can help the health policymakers to select the most appropriate vaccine types in their countries. METHODS Hence, this meta-analysis recapitulates all available data on HPV prevalence and genotypes in women with atypical squamous cells of undetermined significance (ASCUS), cervical intraepithelial neoplasia (CIN) I-III or low- and high-grade squamous intraepithelial lesions (LSIL and HSIL, respectively), and invasive cervical cancer (ICC) in EMRO countries. RESULTS The meta-analysis included 5,990 cases of cervical precancer and cancer. The overall HPV prevalence was 85.4, 71.3, 59.2, and 34.8% in women with ICC, CIN II-III or HSIL, CIN I or LSIL, and ASCUS, respectively. HPV 16 was the most common genotype followed by HPV 18, representing 58 and 16.5% in ICC cases, respectively. CONCLUSION This meta-analysis showed that the introduction of current HPV vaccines into national vaccination programs and the establishment of comprehensive screening programs in EMRO countries is beneficial by preventing 74.5% of cervical neoplasia.
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Affiliation(s)
| | - Mohammad Farahmand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Hosseini
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran,
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Annunziata C, Stellato G, Greggi S, Sanna V, Curcio MP, Losito S, Botti G, Buonaguro L, Buonaguro FM, Tornesello ML. Prevalence of "unclassified" HPV genotypes among women with abnormal cytology. Infect Agent Cancer 2018; 13:26. [PMID: 30061920 PMCID: PMC6056927 DOI: 10.1186/s13027-018-0199-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 07/13/2018] [Indexed: 12/16/2022] Open
Abstract
Background High risk human papillomaviruses (HPVs) have been unequivocally recognised as the necessary cause of squamous intraepithelial lesions (SIL) and invasive carcinoma of the cervix. The distribution and the role of unclassified risk HPV genotypes in cervical neoplasia has not been fully elucidated. Methods Liquid-based cytological samples were collected from 337 women referred for colposcopy following an abnormal cytological diagnosis. HPV DNA was detected by broad-spectrum PCR and genotypes identified by nucleotide sequencing analysis and reverse line blot (RLB). Results The overall frequency of HPV infection was 36.5% (35 out of 96) in samples negative for intraepithelial lesions or malignancy (NILM), 80% (181 out of 226) in low grade SIL and 93.3% (14 out of 15) in high grade SIL (P < 0.001). Thirty-five different genotypes were identified among the 230 HPV-positive cases. The Group 1 oncogenic viruses (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58 and 59) were found in 21.9, 46.5, and 86.7% of NILM, low grade SIL and high grade SIL, respectively. The Group 2A, including the probably oncogenic virus HPV68, was found in 1 and 0.8% of NILM and low grade SIL, respectively. The Group 2b possibly oncogenic HPVs (HPV34, 53, 66, 67, 70, 73, 82 and 85) were found in 4.2, 21.7 and 26.7% of NILM, low grade SIL and high grade SIL, respectively. The unclassified viruses (HPV12, 42, 54, 55, 61, 62, 81, 83, 84, 89, 90, 91) were detected in 8.3 and 14.6% of NILM and low grade SIL, respectively, and never in high grade SIL. Conclusions Group 1 HPVs were mainly prevalent in high grade SIL and low grade SIL while Group 2B were equally distributed among the two groups. The dominant frequency of unclassified HPVs in low grade SIL and NILM and their rarity in high grade SIL suggests their marginal role in cervical neoplasia of the studied population.
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Affiliation(s)
- Clorinda Annunziata
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Giovanni Stellato
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Stefano Greggi
- Gynecology Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Veronica Sanna
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Maria Pia Curcio
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Simona Losito
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Gerardo Botti
- 3Department of Pathology, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", 80131 Naples, Italy
| | - Luigi Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Franco Maria Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
| | - Maria Lina Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori IRCCS "Fondazione G. Pascale", via M Semmola, 80131 Naples, Italy
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Petry KU, Liebrich C, Luyten A, Zander M, Iftner T. Surgical staging identified false HPV-negative cases in a large series of invasive cervical cancers. PAPILLOMAVIRUS RESEARCH (AMSTERDAM, NETHERLANDS) 2017; 4:85-89. [PMID: 29179875 PMCID: PMC5883200 DOI: 10.1016/j.pvr.2017.10.003] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2017] [Revised: 10/16/2017] [Accepted: 10/18/2017] [Indexed: 01/22/2023]
Abstract
OBJECTIVE We examined a large series of biopsy-proven invasive cervical cancers with surgical staging and HPV re-testing to estimate the relevance of HPV-negative cervical cancers in a Caucasian population. METHODS We prospectively collected smears from 371 patients with a biopsy-proven diagnosis of cervical cancer for HC2 testing of high-risk HPV (HR-HPV). In HC2-negative cases, smears and paraffin embedded tissue blocks underwent additional HPV genotyping. RESULTS HC2 tests showed 31/371 cases (8.8%) had negative findings. Surgical staging showed that 21/31 HC2-negative cases (68%) were not cervical cancer. Overall, 340/350 cases of primary cervical cancer confirmed by surgical staging tested HC2 positive (97.2%). Non-high-risk HPV subtypes were detected in five cases (one HPV-53, one HPV-70, and three HPV-73) and high-risk subtypes in four patients with HC2-negative cervical cancer (two HPV 16 and two HPV-18). The remaining case, a primary undifferentiated carcinoma of the uterine cervix, tested negative for HPV-DNA with all tests. CONCLUSIONS The main explanation for HPV-negative cervical cancer was a false diagnosis, followed by cancers associated with non-HR-HPV types, and false-negative HR-HPV results. Truly HPV negative seem to be very rare in Caucasian populations. Retrospective analyses without surgical staging may overestimate the proportion of HPV negative cervical cancers.
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Affiliation(s)
- Karl Ulrich Petry
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany.
| | - Clemens Liebrich
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Alexander Luyten
- Department of Obstetrics and Gynecology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Martina Zander
- Institute of Pathology, Klinikum Wolfsburg, Wolfsburg, Germany
| | - Thomas Iftner
- Institute of Experimental Virology, University of Tübingen, Germany
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Heydari N, Oskouee MA, Vaezi T, Shoja Z, Esmaeili HA, Hamkar R, Shahmahmoodi S, Jalilvand S. Type-specific human papillomavirus prevalence in cervical intraepithelial neoplasia and cancer in Iran. J Med Virol 2017; 90:172-176. [PMID: 28786495 DOI: 10.1002/jmv.24908] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 07/14/2017] [Indexed: 01/19/2023]
Abstract
In Iran, human papillomavirus (HPV) vaccination is not currently included in the national vaccination program and there are no comprehensive approaches to cervical screening program. Regional data on distribution of HPV types in women is important to predict the impact of current HPV vaccines. Although several studies on distribution of HPV types in cervical precancer and cancer have been conducted in Iran, in most of them HPV positive samples were subjected to specific-primer genotyping (mainly 16 and 18), and leaving the other HPV genotypes almost undetermined. Therefore, the present study aimed to investigate the distribution of HPV types in cervical neoplasia from West and Northwest of Iran. A total of 112 women with atypia, cervical intraepithelial neoplasia, and invasive cervical cancer were included. A PCR assay was performed in all samples to detect the presence of the HPV genome using the GP5+/6+ L1 consensus primer set. All HPV positive samples were subjected for sequencing. In overall, HPV prevalence was 20% in atypica, 44.5% in cervical intraepithelial neoplasia I, 92.3% in cervical intraepithelial neoplasia II-III, and 98.2% in invasive cervical cancer. The most frequent HPV type was HPV 16 (79.2%), which was followed by HPV types 18, 6, and 33 at the frequencies of 6.5%, 5.1%, and 2.7%, respectively. The least HPV types were found to be 31, 45, 53, 58, and 66. In conclusion, this study shows that the current HPV vaccines could have great impact to reduce the burden of cervical cancer in Iran.
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Affiliation(s)
- Nasrin Heydari
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahin A Oskouee
- Faculty of Medicine, Department of Microbiology and Virology, Tabriz University of Medical Sciences, Infectious and Tropical Disease Research Center, Tabriz, Iran
| | - Tayebeh Vaezi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Heidar A Esmaeili
- Department of Pathobiology, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Rasool Hamkar
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Shohreh Shahmahmoodi
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.,Tehran University of Medical Sciences, Food Microbiology Research Center, Tehran, Iran
| | - Somayeh Jalilvand
- Department of Virology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Park S, Eom K, Kim J, Bang H, Wang HY, Ahn S, Kim G, Jang H, Kim S, Lee D, Park KH, Lee H. MiR-9, miR-21, and miR-155 as potential biomarkers for HPV positive and negative cervical cancer. BMC Cancer 2017; 17:658. [PMID: 28934937 PMCID: PMC5609051 DOI: 10.1186/s12885-017-3642-5] [Citation(s) in RCA: 103] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 09/05/2017] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Cervical cancer is the second leading cause of death among female patients with cancer in the world. High risk human papillomavirus has causal roles in cervical cancer initiation and progression by deregulating several cellular processes. However, HPV infection is not sufficient for cervical carcinoma development. Therefore, other genetic and epigenetic factors may be involved in this complex disease, and the identification of which may lead to better diagnosis and treatment. Our aim was to analyze the expression of microRNAs in cervical cancer cases positive or negative for HPV E6/E7 mRNA, and to assess their diagnostic usefulness and relevance. METHODS The expression of three different microRNAs (miR-9, miR-21, and miR-155) in 52 formalin-fixed paraffin-embedded (FFPE) primary cervical cancer tissue samples and 50 FFPE normal cervical tissue samples were evaluated. RESULTS MiR-9, miR-21, and miR-155 were significantly overexpressed in cervical cancer tissues compared to normal tissues (P < 0.001). MiR-21 and miR-155 expression combined with the HPV E6/E7 mRNA assay in HPV E6/E7 negative cervical cancer showed increased AUC of 0.7267 and 0.7000, respectively (P = 0.01, P = 0.04), demonstrating their potential as diagnostic tools. Moreover, miR-21 and miR-155 were predictors showing a 7 fold and 10.3 fold higher risk for HPV E6/E7 negative patients with cervical cancer (P = 0.024 and P = 0.017, respectively) while miR-155 was a predictor showing a 27.9 fold higher risk for HPV E6/E7 positive patients with cervical cancer (P < 0.0001). CONCLUSIONS There is a strong demand for additional, alternative molecular biomarkers for diagnosis and management of precancer patients. MiR-21 and miR-155 may be helpful in the prediction of both HPV positive and HPV negative cases of cervical cancer.
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Affiliation(s)
- Sunyoung Park
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Kiyoon Eom
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Jungho Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Hyeeun Bang
- Optipharm M&D, Inc., Wonju Eco Environmental Technology Center, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Hye-Young Wang
- Optipharm M&D, Inc., Wonju Eco Environmental Technology Center, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Sungwoo Ahn
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Geehyuk Kim
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Hyoungsoon Jang
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea
| | - Sunghyun Kim
- Department of Clinical Laboratory Science, College of Health Sciences, Catholic University of Pusan, Pusan, Republic of Korea
| | - Dongsup Lee
- Department of Clinical Laboratory Science, Hyejeon College, Hongseoung, Republic of Korea
| | - Kwang Hwa Park
- Department of Pathology, Wonju College of Medicine, Yonsei University Wonju College of Medicine, 20 Ilsan-ro, Wonju-si, Gangwon-do, 26426, Republic of Korea.
| | - Hyeyoung Lee
- Department of Biomedical Laboratory Science, College of Health Sciences, Yonsei University, Wonju-si, Gangwon-do, 26493, Republic of Korea.
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Giorgi Rossi P, Carozzi F, Federici A, Ronco G, Zappa M, Franceschi S. Cervical cancer screening in women vaccinated against human papillomavirus infection: Recommendations from a consensus conference. Prev Med 2017; 98:21-30. [PMID: 27894910 DOI: 10.1016/j.ypmed.2016.11.020] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 11/14/2016] [Accepted: 11/24/2016] [Indexed: 10/20/2022]
Abstract
In Italy, the cohorts of women who were offered Human papillomavirus (HPV) vaccination in 2007/08 will reach the age (25years) for cervical cancer (CC) screening from 2017. The simultaneous shift from cytology-based screening to HPV test-based screening gives the opportunity for unprecedented reorganisation of CC prevention. The ONS (National Screening Monitoring Centre) Directive and the GISCi (Italian Group for Cervical Screening) identified the consensus conference as the most suitable method for addressing this topic. A summary of consensus recommendations is reported here. The main objective was to define the best screening methods in girls vaccinated against HPV and the knowledge required for defining evidence-based screening strategies. A Jury made recommendations about questions and proposals formulated by a panel of experts representative of Italian scientific societies involved in CC prevention and based on systematic reviews of literature and evidence. The Jury considered changing the screening protocols for girls vaccinated in their twelfth year as appropriate. Tailored screening protocols based on vaccination status could be replaced by "one size fits all" protocols only when a herd immunity effect has been reached. Vaccinated women should start screening at age 30, instead of 25, with HPV test. Furthermore, there is a strong rationale for applying longer intervals for re-screening HPV negative women than the currently recommended 5years, but research is needed to determine the optimal screening time points. For non-vaccinated women and for women vaccinated in their fifteenth year or later, the current protocol should be kept.
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Affiliation(s)
- Paolo Giorgi Rossi
- Epidemiology Unit, Azienda Unità Sanitaria Locale, Via Amendola 2, 42122, Reggio Emilia, Italy; Arcispedale Santa Maria Nuova, Istituto di Ricovero e Cura a Carattere Scientifico - IRCCS, Reggio Emilia, Italy.
| | - Francesca Carozzi
- Cancer Prevention Regional Laboratory, ISPO, Cancer Prevention and Research Institute, Florence, Italy.
| | | | - Guglielmo Ronco
- Center for Cancer Epidemiology and Prevention, AO City of Health and Science, Turin, Italy.
| | - Marco Zappa
- Unit of Clinical and Descriptive Epidemiology, ISPO, Florence, Italy.
| | - Silvia Franceschi
- International Agency for Research on Cancer, 69372 Lyon Cedex 08, France.
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9
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The frequency of Human Papillomavirus Genotypes in Invasive Cervical Cancer of Romanian Patients. REV ROMANA MED LAB 2017. [DOI: 10.1515/rrlm-2017-0008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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10
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Anderson LA, O'Rorke MA, Wilson R, Jamison J, Gavin AT. HPV prevalence and type-distribution in cervical cancer and premalignant lesions of the cervix: A population-based study from Northern Ireland. J Med Virol 2016; 88:1262-70. [PMID: 26680281 DOI: 10.1002/jmv.24447] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2015] [Indexed: 11/05/2022]
Abstract
Assessment of Human papillomavirus (HPV) prevalence and genotype distribution is important for monitoring the impact of prophylactic HPV vaccination. This study aimed to demonstrate the HPV genotypes predominating in pre-malignant and cervical cancers in Northern Ireland (NI) before the vaccination campaign has effect. Formalin fixed paraffin embedded tissue blocks from 2,303 women aged 16-93 years throughout NI were collated between April 2011 and February 2013. HPV DNA was amplified by PCR and HPV genotyping undertaken using the Roche(®) linear array detection kit. In total, 1,241 out of 1,830 eligible samples (68.0%) tested positive for HPV, with the majority of these [1,181/1,830 (64.5%)] having high-risk (HR) HPV infection; 37.4% were positive for HPV-16 (n = 684) and 5.1% for HPV-18 (n = 93). HPV type-specific prevalence was 48.1%, 65.9%, 81.3%, 92.2%, and 64.3% among cervical intraepithelial neoplasias (CIN) Grades I-III, squamous cell carcinomas (SCC) and adenocarcinoma (AC) cases, respectively. Most SCC cases (81.3%) had only one HPV genotype detected and almost a third (32.0%) of all cervical pathologies were HPV negative including 51.9% of CIN I (n = 283), 34.1% CIN II (n = 145), 18.7% of CIN III (n = 146), 7.8% of SCC (n = 5), and 35.7% of AC (n = 5) cases. This study provides important baseline data for monitoring the effect of HPV vaccination in NI and for comparison with other UK regions. The coverage of other HR-HPV genotypes apart from 16 and 18, including HPV-45, 31, 39, and 52, and the potential for cross protection, should be considered when considering future polyvalent vaccines.
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Affiliation(s)
- Lesley A Anderson
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Michael A O'Rorke
- Cancer Epidemiology and Health Services Research Group, Centre for Public Health, School of Medicine Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
| | - Robbie Wilson
- Department of Cellular and Molecular Pathology, Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - Jackie Jamison
- Department of Cellular and Molecular Pathology, Antrim Area Hospital, Northern Health and Social Care Trust, Antrim, Northern Ireland
| | - Anna T Gavin
- Northern Ireland Cancer Registry, Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, Northern Ireland
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11
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Miller RA, Waters LL, Mody DR, Tams KC. Squamous cell carcinoma of the cervix: a cytology-histology-human papillomavirus correlation in clinical practice. Arch Pathol Lab Med 2015; 139:776-81. [PMID: 26030246 DOI: 10.5858/arpa.2014-0202-oa] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
CONTEXT Cervical cancer mortality has declined by 74% in the United States since the implementation of the Papanicolaou (Pap) test. Nevertheless, more than 12,000 US women annually develop cervical cancer, and squamous cell carcinoma (SqCa) remains the predominant cervical malignancy. OBJECTIVE To evaluate screening techniques used in the detection of SqCa of the cervix and provide insights regarding which technique(s) is (are) most efficacious in our study population. DESIGN We retrospectively reviewed all available cytologic, human papillomavirus (HPV), and histologic malignancy burden data from patients diagnosed with SqCa. The clinical data were collected from 2 geographically and socioeconomically diverse hospital systems. Cases in which identified patients had a Pap test with a negative result/unsatisfactory specimen within 5 years of SqCa tissue diagnosis were considered Pap test screening failures. Cases in which patients were diagnosed with HPV-negative SqCa were considered HPV screening failures. RESULTS Eighty-eight cases (patients' ages ranging from 19 to 73 years) were identified. Of those, cytologic history was available for 64 cases present in our electronic medical history record. Three cases were cytology screening failures (one being an unsatisfactory specimen) and 3 cases were HPV screening failures (one being the cytologic unsatisfactory case). Although measuring sensitivity in practice has limitations, we calculated the SqCa detection sensitivity at 95.3% by Pap test alone and 97% when HPV DNA testing was incorporated. CONCLUSIONS Our results highlight the necessity of combining Pap and HPV testing. Although the number of cases identified is relatively small, our data suggest detection failures will decrease as the practice of combining HPV and Pap testing increases.
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Affiliation(s)
- Ross A Miller
- From the Department of Pathology, University of South Dakota, Sioux Falls (Dr Miller); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Drs Waters and Mody); and Sanford Health Pathology Clinic, Sanford USD Medical Center, Sioux Falls, South Dakota (Dr Tams). Dr Miller is now at the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas. Dr Waters is now at the Department of Pathology, Medical City, Dallas, Texas
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12
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Miller RA, Mody DR, Tams KC, Thrall MJ. Glandular Lesions of the Cervix in Clinical Practice: A Cytology, Histology, and Human Papillomavirus Correlation Study From 2 Institutions. Arch Pathol Lab Med 2015; 139:1431-6. [DOI: 10.5858/arpa.2014-0633-oa] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
ContextThe Papanicolaou (Pap) test has indisputably decreased cervical cancer mortality, as rates have declined by up to 80% in the United States since its implementation. However, the Pap test is considered less sensitive for detecting glandular lesions than for detecting those of squamous origin. Some studies have even suggested an increasing incidence of cervical adenocarcinoma, which may be a consequence of a relatively reduced ability to detect glandular lesions with cervical cancer screening techniques.ObjectiveTo evaluate the detection rate of glandular lesions with screening techniques currently used for cervical cancer screening and to provide insight as to which techniques are most efficacious in our study population.DesignWe retrospectively reviewed any available cytology, human papillomavirus (HPV), and histologic malignancy data in patients diagnosed with adenocarcinoma in situ and adenocarcinoma from 2 geographically and socioeconomically disparate hospital systems. Identified patients having had a negative/unsatisfactory Pap test within 5 years of adenocarcinoma in situ or adenocarcinoma tissue diagnosis were considered Pap test screening failures. Patients with negative HPV tests on cytology samples were considered HPV screening failures.ResultsOne hundred thirty cases were identified (age range, 22–93 years); 39 (30%) had no Pap history in our files. Eight of 91 remaining cases (8.8%) were screening failures. The detected sensitivity for identifying adenocarcinoma in situ/adenocarcinoma in this study was 91.2% by cytology alone and 92.3% when incorporating HPV testing. The most common cytologic diagnosis was atypical glandular cells (25 cases), and those diagnosed with adenocarcinoma were 7.4 years older than those diagnosed with adenocarcinoma in situ (50.3 versus 42.9 years). Nine of 24 HPV-tested cases (37.5%) were called atypical squamous cell of undetermined significance on cytology.ConclusionsOur results highlight the importance of combined Pap and HPV cotesting. Although the number of cases identified is relatively small, our data suggest screening for squamous lesions facilitates the recognition of glandular lesions in the cervix. Additionally, increased use of combined Pap and HPV cotesting may decrease detection failure rates with regard to glandular lesions.
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Affiliation(s)
| | | | | | - Michael J. Thrall
- From the University of South Dakota Pathology Residency Program, Sioux Falls (Dr Miller); the Department of Pathology and Genomic Medicine, Houston Methodist Hospital, Houston, Texas (Drs Mody and Thrall); and the Sanford Health Pathology Clinic, University of South Dakota Medical Center, Sioux Falls (Dr Tams). Dr Miller is now with the Department of Pathology and Genomic Medicine, Houston Method
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Guo Y, Hu J, Zhu L, Sun J, Xie L, Kong F, Han L, Li F. Physical Status and Variant Analysis of Human Papillomavirus 16 in Women from Shanghai. Gynecol Obstet Invest 2015; 81:61-70. [DOI: 10.1159/000381775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 03/18/2015] [Indexed: 11/19/2022]
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Lönnberg S, Hansen BT, Haldorsen T, Campbell S, Schee K, Nygård M. Cervical cancer prevented by screening: Long-term incidence trends by morphology in Norway. Int J Cancer 2015; 137:1758-64. [DOI: 10.1002/ijc.29541] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 03/24/2015] [Indexed: 11/06/2022]
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Boumba LMA, Hilali L, Mouallif M, Moukassa D, Ennaji MM. Specific genotypes of human papillomavirus in 125 high-grade squamous lesions and invasive cervical cancer cases from Congolese women. BMC Public Health 2014; 14:1320. [PMID: 25539861 PMCID: PMC4391118 DOI: 10.1186/1471-2458-14-1320] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2014] [Accepted: 12/15/2014] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Knowledge on HPV prevalence and genotype distribution in HSIL and ICC is highly essential for the introduction of an effective vaccination program and appropriate epidemiological monitoring of viral ecology before and after vaccination in Congo. This study aimed to determine the specific-HPV genotypes in HSIL and ICC among women in southwestern Congo. METHODS 125 archival paraffin-embedded biopsy collected between 2008 and 2012 and histologically diagnosed were investigated. DNA extraction was performed using the phenol/chloroform method. HPV search was performed by nested-PCR using MY09/MY11 and GP5+/GP6+ consensus primers followed by direct sequencing. RESULTS The mean age of participants was 44.3 ± 8.2 years. Overall, HPV prevalence was 89.6% (112/125) with all high-risk genotypes. HPV-DNA was detected in 81.5% (53/65) of HSIL and 98.3% (59/60) of ICC. HPV 16 the most common genotype was detected in 47.1% (25/53) of HSIL and 52.5% (31/59) of ICC. Other types identified were: HPV 33 (22.6%), HPV 18 (15%), HPV 31 (11.3%) and HPV 69 (3.7%) in HSIL, and HPV 33 (28.8%), HPV 18 (11.8%), HPV 31 (5%) and HPV 35 (1.7%) in ICC. Knowing that the ADC accounted for 6.7% (4/60) of ICC cases, HPV 18 was identified in 25% (1/4) of these cases against 75% (3/4) for HPV 16. CONCLUSION Our study showed that HPV 16, 33, 18 and 31 were the four most common genotypes in women with HSIL and ICC. These findings indicate that current vaccines against HPV could help to reduce the burden of cervical cancer in Congo.
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Affiliation(s)
- Luc Magloire Anicet Boumba
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc. .,Laboratoire d'Agroalimentaire et Santé, Département de Biologie Appliquée, Faculté des Sciences et Techniques, Université Hassan 1er Settat, B.P. 577, Settat, Maroc. .,Laboratoire d'Analyses Médicales et Morphologiques, Hôpital Général de Loandjili, B.P. 8122, Pointe-Noire, Congo.
| | - Lahoucine Hilali
- Laboratoire d'Agroalimentaire et Santé, Département de Biologie Appliquée, Faculté des Sciences et Techniques, Université Hassan 1er Settat, B.P. 577, Settat, Maroc.
| | - Mustapha Mouallif
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc. .,Institut Supérieur des Sciences de la santé, Université Hassan 1er Settat, B.P. 577, Settat, Maroc.
| | - Donatien Moukassa
- Laboratoire d'Analyses Médicales et Morphologiques, Hôpital Général de Loandjili, B.P. 8122, Pointe-Noire, Congo.
| | - Moulay Mustapha Ennaji
- Laboratoire de Virologie, Microbiologie et Qualité/ETB, Faculté des Sciences et Techniques, Université Hassan II Mohammedia, B.P. 146, Mohammedia, 20650, Maroc.
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Jalilvand S, Shoja Z, Nourijelyani K, Tohidi HR, Hamkar R. Meta-analysis of type-specific human papillomavirus prevalence in Iranian women with normal cytology, precancerous cervical lesions and invasive cervical cancer: Implications for screening and vaccination. J Med Virol 2014; 87:287-95. [DOI: 10.1002/jmv.24053] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/29/2014] [Indexed: 01/12/2023]
Affiliation(s)
- Somayeh Jalilvand
- Virology Department; School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | | | - Keramat Nourijelyani
- Biostatistics Department; School of Public Health; Tehran University of Medical Sciences; Tehran Iran
| | - Hamid Reza Tohidi
- Faculty of Health; Gonabad University of Medical Sciences; Gonabad Iran
- Non-Communicable Diseases Research Center; Endocrinology and Metabolism Population Science Institute; Tehran University of Medical Sciences; Tehran Iran
| | - Rasool Hamkar
- Virology Department; School of Public Health; Tehran University of Medical Sciences; Tehran Iran
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The impact of HPV female immunization in Italy: model based predictions. PLoS One 2014; 9:e91698. [PMID: 24618824 PMCID: PMC3950270 DOI: 10.1371/journal.pone.0091698] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2013] [Accepted: 02/13/2014] [Indexed: 12/04/2022] Open
Abstract
The Human Papillomavirus (HPV) is a sexually transmitted virus that causes cervical cancer. Since 2008 a vaccination program targeting 12-year-old girls has been initiated in Italy, backing up the cervical screening program already active since 1996. We propose a mathematical model of HPV transmission dynamics with the aim of evaluating the impact of these prevention strategies. The model considers heterosexual transmission of HPV types 16 and 18, structured by sex, age and sexual activity level, where transition to sexual activity is explicitly modeled from recent survey data. The epidemiological structure is a hybrid SIS/SIR, where a fraction of individuals recovering from infection develops permanent immunity against reinfection. Infections may progress to cervical lesions and cancer and heal spontaneously or upon treatment. Women undergoing hysterectomy (either after treatment of HPV lesions or by other causes) also transmit HPV infection. The model fits well both the age-specific prevalence of HPV infections and the incidence of cervical cancers in Italy, and accurately reproduces the decreasing trend in cancer incidence due to the introduction of the screening program. The model predicts that if the screening coverage is maintained at current levels, even in the absence of vaccination, such trend will continue in the next few decades, eventually plateauing at 25% below the current level. The additional initiation of routine vaccination targeting 12-year-old girls will further reduce cervical cancer incidence by two thirds at equilibrium, under realistic assumptions of 70% coverage and a duration of protective immunity of 50 years. If catch-up immunization of 25-year-old women at first cervical screening is also introduced, about 3,000 cervical cancer cases overall can be averted, corresponding to 9.6% of all cases expected in the scenario without catch-up. We conclude that HPV vaccination in addition to cervical screening will significantly reduce the burden of cervical cancer in Italy.
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Tornesello ML, Giorgi Rossi P, Buonaguro L, Buonaguro FM. Human Papillomavirus Infection and Cervical Neoplasia among Migrant Women Living in Italy. Front Oncol 2014; 4:31. [PMID: 24600587 PMCID: PMC3929937 DOI: 10.3389/fonc.2014.00031] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2013] [Accepted: 02/03/2014] [Indexed: 11/13/2022] Open
Abstract
Human papillomavirus (HPV) infection is highly prevalent in women migrating from countries where cervical screening is not implemented. The variety of HPV genotypes, their prevalence and the association with cervical abnormalities has been investigated by several groups in women moving mainly from Eastern Europe, Africa, and Southern Asia to Italy. All studies are concordant on the elevated rate of HPV infection among immigrants, which is four times higher than that observed among age-matched Italian women. The HPV prevalence among short-term migrants and characterization of viral variants showed that the high prevalence of HPV reflects either individual lifestyle or high prevalence of HPV in the country of origin. The high burden of HPV infection correlates very well with the high incidence of cervical cancer in migrant women. In fact, during the years 2000-2004 the cervical cancer incidence in women from Central and Eastern Europe and living in Central Italy was 38.3 per 100,000, which is statistically significant higher than that of native Italian women (6 per 100,000). In this study, we pooled together the results of three independent studies originally designed to assess the distribution and the prevalence of HPV genotypes among 499 immigrant women living in Southern Italy. A total of 39 mucosal HPV genotypes were identified. The 12 genotypes (HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59) classified as carcinogenic to humans (group 1) accounted for >80% of all infections. HPV16 was the most common viral type in all groups with frequency rates ranging from 15.4% in Africa to 51.1% in Eastern and Southern European HPV-positive women. The high prevalence of oncogenic HPVs and cervical cancer risk among migrant women, together with the lower participation in screening programs, demands for an urgent implementation of preventive strategies to increase screening and vaccine coverage and viral monitoring of uncommon HPV genotypes potential spreading in settled population.
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Affiliation(s)
- Maria Lina Tornesello
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori "Fondazione G Pascale" - IRCCS , Naples , Italy
| | - Paolo Giorgi Rossi
- Servizio Interaziendale di Epidemiologia, Azienda Unità Sanitaria Locale and IRCCS, Arcispedale Santa Maria Nuova , Reggio Emilia , Italy
| | - Luigi Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori "Fondazione G Pascale" - IRCCS , Naples , Italy
| | - Franco Maria Buonaguro
- Molecular Biology and Viral Oncology Unit, Istituto Nazionale Tumori "Fondazione G Pascale" - IRCCS , Naples , Italy
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