Type-specific prevalence of human papillomavirus by cervical cytology among women in Brasov, Romania

CINtec PLUS: A Novel Alternative Screening Method for Detecting High-Risk Cervical Lesions in Romania

Introduction CINtec PLUS is a relatively recent method introduced in Romania for detecting cervical precancerous lesions. This technique utilizes simultaneous double immunostaining with p16 and Ki67 to identify potentially transformative human papillomaviruses (HPVs). CINtec PLUS has demonstrated superior sensitivity and specificity compared to conventional Papanicolaou (PAP) cytology and PAP liquid-based cytology, allowing for more accurate identification of HPV infections that may progress to malignancy among women with abnormal screening results. The objectives of this study are to evaluate CINtec PLUS test results in comparison with PAP cytology and HPV genotype detection among Romanian women and to assess its potential as a complementary screening method within existing national cervical cancer screening programs. Materials and methods Cases were collected between December 22, 2022, and June 15, 2024. All 96 women enrolled in the study, regardless of the presence of pathological cervical lesions, underwent the CINtec PLUS test. The samples were stained using the Roche CINtec PLUS kit. Statistical analyses were performed using IBM SPSS Statistics for Windows, Version 26.0 (Released 2019; IBM Corp., Armonk, NY, USA). To assess correlations and compare variables, we utilized crosstabulation tables, frequency tables, the chi-square test, and the Pearson correlation coefficient. Results The age range of participants in our study was from 19 to 64 years, with a mean age of 35.77 years and a standard deviation of 9.608. Among the women who underwent the CINtec PLUS test, over two-thirds were aged between 20 and 39 years. In 7.3% of cases with no history of HPV infection or cervical cytologic lesions, the CINtec PLUS test yielded a positive result. The study also revealed that CINtec PLUS showed a positive result in 23.3% of cases diagnosed with atypical squamous cells of undetermined significance on PAP cytology. Additionally, 36.5% of women who underwent CINtec PLUS testing as a screening method had a positive result, with more than one-fifth of these cases being positive. Conclusions The CINtec PLUS test is a valuable tool for identifying high-risk cervical lesions. Despite the limitations of our study, it provides a foundation for further research into the long-term benefits and cost-effectiveness of this test. Future studies could explore its potential for integration into national screening programs.

Distribution of vaccine-related high-risk human papillomaviruses and their impact on the development of cervical dysplasia in women in Montenegro

Cervical cancer (CC) is the third leading cause of death in women in Montenegro. Human papillomavirus (HPV) is the causative agent of CC however, HPV genotype distribution varies across regions. This study examined the distribution and impact of vaccine-related high-risk (HR)-HPVs on the development of cervical dysplasia in Montenegrin women. A total of 187 women who had a clinical indication for cervical biopsy were enrolled. Based on histopathological findings, women were classified into 2 groups, with and without dysplasia. HR-HPV was detected by real-time PCR. Twelve HR-HPV genotypes were detected in 40.6% of cervical samples. The 7 most prevalent HR-HPVs in order of decreasing frequency were HPV 16 (39.5%), 45 (23.7%), 31 (21.0%), 33 (17.1%), 18 (6.6%), 52 (6.6%), and 58 (6.6%), all of them are targeted by nonavalent vaccine. Vaccine-related HR-HPVs had a higher prevalence (92.1%) than the other HR-HPVs detected in HR-HPV-positive samples. Among HR-HPV-positive women, HPV 16 and 33 were more common in women with dysplasia than in those without dysplasia (HPV 16: 28.9 vs 7.2%; HPV 33: 11.8 vs 3.6%). HPV 16 was the most common HR-HPV genotype in cervical samples, followed by HPV 45, 31, 33, 18, 52, and 58. HPV 16 and 33 were shown to be associated with the development of cervical dysplasia. These results indicate that prophylactic nonavalent vaccine can potentially prevent approximately 90% of HR-HPV infections and 60% of cervical dysplasia cases in Montenegrin women.

Genotype distribution and prevalence of human papillomavirus among women with cervical cytological abnormalities in Xinjiang, China

Background: Genotype distribution and prevalence of human papillomavirus (HPV) among women vary from different regions and crowds, prophylactic HPV vaccin could prevent some diseases related to HPV, which include cervical precancerous lesions and cancer. Baseline surveys prior to mass HPV vaccination are critical to determine vaccine efficacy and detect changes in HPV type after vaccination. Objective: The aim of this study is to study the HPV type-specific prevalence in 698 women with cytological abnormalities, aging from 18 to 77 years old. Additionally, the association between HPV infection and cervical disease was investigated as well. Methods: A total of 698 cervical specimens of cytological abnormalities were collected from the First Affiliated Hospital of Xinjiang Medical University. The Thinprep liquid-based cytologic test (TCT) was performed and the cytological status was classified according to Bethesda 2001. The samples were tested HPV genotype by the PCR-based hybridization gene chip assay. Results: Overall, the HPV prevalence was 54.87%, and it was shown to be age dependent, and with the decreasing and zigzag prevalence until the age of 55 years. 204 patients (53.26%) were infected with pure high-risk HPV, 139 (36.30%) with pure low-risk HPV, and 40 (10.44%) with mixed HPV types. HPV16 was the most common type (35.36%), followed by HPV58 (13.62%) and HPV52 (9.15%). In this study, 386 (55.30%) were affected by ASCUS, 11 (1.58%) by ASC-H, 137 (19.63%) by L-SIL and 151 (21.63%) by H-SIL. Women with a cytology result of ASCUS, ASC-H, L-SIL and H-SIL had the infection of HPV 39.12%, 54.17%, 70.80% and 80.79% respectively. Conclusions: In conclusion, this study presents the first investigation about the prevalence of HPV infection and HPV genotype distribution in Xinjiang women who have abnormal cytological tests. Prior to HPV immunization in Xinjiang's population, our results could be baseline data and validation set, which provide robust available estimates of the prevalence of type-specific HPV.

Prevalence of human papillomavirus infection and genotyping for population-based cervical screening in developed regions in China

We conducted a cross-sectional analysis to assess the distribution of human papillomavirus (HPV) types and explored an acceptable strategy for cervical screening in Shenzhen, China. A total of 2717 individuals ranging in age from 30–59 years were recruited. Clinical sensitivity and specificity as well as positive (PPV) and negative (NPV) predictive values were estimated. A triage strategy was regarded as acceptable when the NPV was at least 98.0%. 432 (15.9%) participants presented HPV positive. The five most prevalent HPV types were HPV52 (22.9%), HPV16 (12.7%), HPV53 (10.0%), HPV51 (8.6%), and HPV58 (8.1%). The CIN2+ risks for each HPV type were 40.0% for HPV33, 32.4% for HPV16, 18.2% for HPV58, 13.3% for HPV56, and 11.1% for HPV68 in descending order. Baseline cytology testing combined with HPV16/33/52/58 genotyping met the NPV thresholds at 98.6% with a PPV of 17.9%, demonstrating excellent clinical performance for detecting HPV types in CIN2+ patients. In conclusion, triaging HPV-positive women by baseline cytology combined with HPV16/58/33/52 genotyping is an acceptable strategy for cervical cancer screening in Shenzhen, China.

HPV prevalence and type distribution in Cypriot women with cervical cytological abnormalities

BACKGROUND

Human papillomavirus (HPV) is the most common sexually transmitted agent, and it can cause cervical lesions and cancer in females. Currently, information regarding the prevalence of HPV in Cyprus is lacking. The aim of this study was to evaluate the HPV type-specific prevalence in 596 women, aged 19-65 years, with cytological abnormalities. Additionally, in a subset of 348 women for whom cytology results of the Pap test were available, the association between HPV infection and cervical disease was investigated.

METHODS

HPV detection and typing was carried out using PCR and restriction fragment length polymorphism analysis, respectively.

RESULTS

Overall, the HPV prevalence was 72.8%, and it was shown to be age dependent, with a decreasing prevalence until the age of 45 years (p = 0.0018, χ²). Two hundred and fifty-eight women (59.4%) were infected with high-risk HPV, 151 (34.8%) with low-risk HPV, and 25 (5.8%) with HPV types of unknown risk. The most common high-risk HPV type was HPV16 (17.7%), followed by HPV31 (12.9%), HPV58 (7.1%), HPV68 (4.6%), HPV18 (4.1%), and HPV56 (3.7%). Among the women for whom cytology results were available, 268 (77%) were HPV positive, with a sample distribution as follows: 188 (74%) had atypical squamous cells of undetermined significance (ASCUS), 61 (85.9%) had low-grade squamous intraepithelial lesion (L-SIL), and 19 (82.6%) had high-grade squamous intraepithelial lesion (H-SIL). HPV16 was the most common type among women affected by L-SIL (19.7%) and H-SIL (15.8%), with HPV31 being the most common type in women affected by ASCUS (16.5%).

CONCLUSIONS

The present study provides the first epidemiological data related to HPV prevalence and type distribution in Cypriot women with cytological abnormalities.

The Prevalence of Cervical Human Papillomavirus Infection and the Most At-risk Genotypes Among Iranian Healthy Women: A Systematic Review and Meta-analysis

BACKGROUND

One of the most common sexual-transmitted infections among women is human papillomavirus (HPV) infection which is associated with genital cancers. Different studies in Iran reported various prevalences, and combining their results could be important for health policy makers. This study aims to determine the total prevalence of HPV infection as well as its related genotypes, particularly HPV16 and HPV18 among Iranian healthy women.

METHODS

Searching the Scientific Information Database, Iranmedex, Magiran, Irandoc, PubMed, Google Scholar, Scopus, and ScienceDirect databanks using relevant keywords and excluding duplicates and irrelevant evidence followed by applying exclusion criteria and quality assessment, eligible articles were selected. Standard error of the prevalence was calculated based on binomial distribution. Random effects model was used because of the high heterogeneity among the results.

RESULTS

Of 14 studies entered into the systematic review, 24 pieces of evidence reported the HPV prevalence among 7655 healthy and noncancerous women in different Provinces of Iran. Total prevalence of HPV, 9.4% (95% confidence interval [CI]: 6.8-12.02); HPV16, 2.03% (95% CI: 1.3-2.8); HPV18, 1.7% (95% CI: 0.9-2.5); and other genotypes of HPV, 5.3% (95% CI: 3.6-6.9) were estimated.

CONCLUSIONS

Our meta-analysis showed that the total prevalence of HPV and its high-risk genotypes (16 and 18) among healthy noncancerous Iranian women was very high.

Characteristic features of cytotoxic activity of flavonoids on human cervical cancer cells

Cervical cancer is the most common gynecologic malignancy worldwide and development of new therapeutic strategies and anticancer agents is an urgent priority. Plants have remained an important source in the search for novel cytotoxic compounds and several polyphenolic flavonoids possess antitumor properties. In this review article, data about potential anticarcinogenic activity of common natural flavonoids on various human cervical cancer cell lines are compiled and analyzed showing perspectives for the use of these secondary metabolites in the treatment of cervical carcinoma as well as in the development of novel chemotherapeutic drugs. Such anticancer effects of flavonoids seem to differentially depend on the cellular type and origin of cervical carcinoma creating possibilities for specific targeting in the future. Besides the cytotoxic activity per se, several flavonoids can also contribute to the increase in efficacy of conventional therapies rendering tumor cells more sensitive to standard chemotherapeutics and irradiation. Although the current knowledge is still rather scarce and further studies are certainly needed, it is clear that natural flavonoids may have a great potential to benefit cervical cancer patients.