Prevalence of High-Risk Human Papillomavirus Types and Their Association with Cervical Squamous Cell Carcinoma, and High- and Low-Grade Squamous Intraepithelial Lesions in Turkish Women
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Abstract
Background: This study aimed to investigate human papillomavirus (HPV) type prevalence in our region and the relationship between uterine cervical HPV types and squamous cell carcinoma (SCC)/intraepithelial lesions.
Methods: HPV test results were obtained from patient file archives of the Gynecology and Obstetrics Clinic. Pathology report results were obtained from the digital records of the Pathology Laboratory and the patient file archives of the Gynecology and Obstetrics Clinic in 2018.
Results: The most frequently detected was HPV16 (29.2%), followed by HPV51 (13.1%), HPV56 (11%), HPV31 (9.2%), HPV52 (8.4%), and HPV68 (8.2%). HPV16 was positive in 50% of patients diagnosed with SCC, 54.9% of patients with HSIL, 27% of patients with LSIL, and 25% of cases diagnosed as benign (P<0.001). HPV18 was positive in 25% of patients diagnosed with SCC, 11% of patients with HSIL, 4.7% of patients with LSIL, and 5.2% of cases diagnosed as benign (P=0.019).
Conclusion: The most frequent hrHPV genotype was HPV16, followed by HPV51, HPV 56, and HPV 31. There is an increase in the frequency of HPV51 and HPV56. HPV51, not included in HPV vaccines and is the second most frequent, should be included in these vaccines. In addition, although the frequency of HPV18 has decreased, HSIL and SCC generation is still high together with HPV16.
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2. Giuliano AR, Harris R, Sedjo RLو et al (2002). Incidence, prevalence, and clear-ance of type-specific human papilloma-virus infections: The Young Women’s Health Study. J Infect Dis, 186(4), 462-9.
3. Catteau, X., Simon, P., Noël, J. C. (2014). Evaluation of the oncogenic human pap-illomavirus DNA test with liquid-based cytology in primary cervical cancer screening and the importance of the ASC/SIL ratio: a Belgian study. ISRN Obstet Gynecol, 2014:536495.
4. Capra G, Giovannelli L, Bellavia C, et al (2008). HPV genotype prevalence in cyto-logically abnormal cervical samples from women living in southern Italy. Virus Res, 133(2), 195-200.
5. Dürst M, Glitz D, Schneider A, et al (1992). Human papillomavirus type 16 (HPV 16) gene expression and DNA replication in cervical neoplasia: analysis by in situ hy-bridization. Virol, 189(1), 132-40.
6. Argyri E, Papaspyridakos S, Tsimplaki E, et al (2013). A cross-sectional study of HPV type prevalence according to age and cy-tology. BMC Infectious Diseases, 13(1), 1-8.
7. Dickson EL, Vogel RI, Geller MA, et al (2014). Cervical cytology and multiple type HPV infection: a study of 8182 women ages 31–65. Gynecol Oncol, 133(3), 405-8.
8. Zuna RE, Allen RA, Moore WE, et al (2007). Distribution of HPV genotypes in 282 women with cervical lesions: evidence for three categories of intraepithelial lesions based on morphology and HPV type. Mod Pathol, 20(2), 167-74.
9. Park E, Kim JY, Choi S, et al (2019). Car-cinogenic risk of human papillomavirus (HPV) genotypes and potential effects of HPV vaccines in Korea. Sci Rep, 9(1):12556.
10. Agarossi A, Ferrazzi E, Parazzini F, et al (2009). Prevalence and type distribution of high‐risk human papillomavirus infec-tion in women undergoing voluntary cer-vical cancer screening in Italy. J Med Virol, 81(3), 529-35.
11. Arroyo SL, Basaras M, Arrese E, et al (2012). Human papillomavirus (HPV) genotype 18 variants in patients with clin-ical manifestations of HPV-related infec-tions in Bilbao, Spain. Virol J, 9: 258.
12. Krashias G, Koptides D, Christodoulou C (2017). HPV prevalence and type distribu-tion in Cypriot women with cervical cyto-logical abnormalities. BMC Infect Dis, 17(1):346.
13. Delgado D, Marín JM, de Diego J, et al (2012). Human papillomavirus (HPV) genotype distribution in women with ab-normal cervical cytology in the Basque Country, Spain. Enferm Infecc Microbiol Clin, 30(5): 230-5.
14. Meloni A, Pilia R, Campagna M, et al (2014). Prevalence and molecular epidemiology of human papillomavirus infection in Ital-ian women with cervical cytological ab-normalities. J Public Health Res, 3(1):157.
15. Panotopoulou E, Tserkezoglou A, Kouvousi M, et al (2007). Prevalence of human pap-illomavirus types 6, 11, 16, 18, 31, and 33 in a cohort of Greek women. J Med Virol, 79(12): 1898-905.
16. Rassu M, Bertoloni G, Mengoli C, et al (2005). HPV genotype prevalence in cer-vical specimens with abnormal cytology: a report from northeast Italy. Scand J Infect Dis, 37(6-7):476-81.
17. Simanaviciene V, Gudleviciene Z, Popendikyte V, et al (2015). Studies on the prevalence of oncogenic HPV types among Lithuanian women with cervical pathology. J Med Virol, 87(3): 461-71.
18. Spinillo A, Dal Bello B, Gardella B, et al (2009). Multiple human papillomavirus in-fection and high-grade cervical intraepi-thelial neoplasia among women with cy-tological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions. Gynecol Oncol, 113(1):115-9.
19. Yapijakis C, Adamopoulou M, Antonopou-los G, et al (2008). Prevalence of HPV types in a cohort of Greeks with clinical indication of infection. Anticancer Res, 28(4B):2233-7.
20. He L, He J. (2019). Distribution of high-risk HPV types among women in Sichuan province, China: a cross-sectional study. BMC Infect Dis, 19(1): 390.
21. Bakir A, Alacam S, Karabulut N, et al (2021). Evaluation of human papillomavirus genotype distribution in cervical samples. J Cytol, 38(1):44-49.
22. AYDOĞAN S, YAZGAN A, Emre Erdem TAŞ, et al (2018). The presence and dis-tribution of high-risk HPV types in sim-ultaneous cervical cytology samples. Turk Bull Hyg Exp Biol, 75(1): 13-20.
23. Yan X, Huang Y, Zhang M, et al (2020). Prevalence of human papillomavirus in-fection and type distribution among Uy-ghur females in Xinjiang, northwest Chi-na. Oncol Lett, 20(4):25.
24. Güçkan R, Kılınç Ç, Gözdemir E, et al (2016). Prevalence and distribution of high-risk human papillomavirus in Amasya region, Turkey. Biomed Res, 27(3): 769-72.
25. Pista A, Oliveira A, Verdasca N, et al (2011). Single and multiple human papillomavirus infections in cervical abnormalities in Portuguese women. Clin Microbiol Infect, 17(6): 941-6.
26. Bello BD, Spinillo A, Alberizzi P, et al (2009). Cervical infections by multiple human papillomavirus (HPV) genotypes: preva-lence and impact on the risk of precan-cerous epithelial lesions. J Med Virol, 81(4):703-12.
27. Campos-Romero A, Anderson KS, Longat-to-Filho A, et al (2019). The burden of 14 hr-HPV genotypes in women attending routine cervical cancer screening in 20 states of Mexico: a cross-sectional study. Sci Rep, 9(1):10094.
28. Dursun P, Ayhan A, Mutlu L, et al (2013). HPV Types in Turkey: Multicenter Hospi-tal Based Evaluation of 6388 Patients in Turkish Gynecologic Oncology Group Centers/Türkiye’deki HPV Tipleri: Türk Jinekolojik Onkoloji Grubuna Üye Merkezlere Başvuran 6388 Hastanın Ret-rospektif Analizi. Turk J Pathol, 29(3):210-6.
29. Şahin HÖ, Gürlek B (2019). Distribution of Human Papillomavirus Genotypes and Cervical Cytology Results at A Tertiary Center in The Eastern Black Sea Region of Turkey. Med Sci, 14(4):205-13.
30. Özen S, Çimentepe M, Vardar MA, et al (2018). Anormal Servikal Sitolojili Kadın-larda Human Papillomavirüs Genotiple-rinin Prevalansı. Flora J Infect Dis Clin Mi-crobiol, 23(4): 186-92.
31. Muderris T, Afsar I, Yıldız A, et al (2019). HPV genotype distribution among wom-en with normal and abnormal cervical cy-tology in Turkey. Rev Esp Quimioter, 32(6): 516-524.
32. Demirci M, Guzel AD, Ersahin AA, et al (2019). Human papillomavirus prevalence and genotype distribution among Turkish women with or without cervical lesion. Indian Journal of Medical Microbiology, 36(4): 517-521.
33. Eroglu S, Asgin N. (2020). Frequency and genotype distribution of high-risk human papillomavirus types in Karabuk prov-ince, Turkey: A hospital-based cross-sectional study. Ann Med Res, 27(3):765-9.
34. Coscia MF, Monno R, Ballini A, et al (2015). Human papilloma virus (HPV) genotypes prevalence in a region of South Italy (Apulia). Ann Ist Super Sanita, 51(3):248-51.
35. Gargiulo F, De Francesco MA, Schreiber C, et al (2007). Prevalence and distribution of single and multiple HPV infections in cytologically abnormal cervical samples from Italian women. Virus Res, 125(2):176-82.
36. Robadi IA, Pharaon M, Ducatman BS (2018). The importance of high-risk hu-man papillomavirus types other than 16 and 18 in cervical neoplasia. Arch Pathol Lab Med, 142(6):693-695.
2. Giuliano AR, Harris R, Sedjo RLو et al (2002). Incidence, prevalence, and clear-ance of type-specific human papilloma-virus infections: The Young Women’s Health Study. J Infect Dis, 186(4), 462-9.
3. Catteau, X., Simon, P., Noël, J. C. (2014). Evaluation of the oncogenic human pap-illomavirus DNA test with liquid-based cytology in primary cervical cancer screening and the importance of the ASC/SIL ratio: a Belgian study. ISRN Obstet Gynecol, 2014:536495.
4. Capra G, Giovannelli L, Bellavia C, et al (2008). HPV genotype prevalence in cyto-logically abnormal cervical samples from women living in southern Italy. Virus Res, 133(2), 195-200.
5. Dürst M, Glitz D, Schneider A, et al (1992). Human papillomavirus type 16 (HPV 16) gene expression and DNA replication in cervical neoplasia: analysis by in situ hy-bridization. Virol, 189(1), 132-40.
6. Argyri E, Papaspyridakos S, Tsimplaki E, et al (2013). A cross-sectional study of HPV type prevalence according to age and cy-tology. BMC Infectious Diseases, 13(1), 1-8.
7. Dickson EL, Vogel RI, Geller MA, et al (2014). Cervical cytology and multiple type HPV infection: a study of 8182 women ages 31–65. Gynecol Oncol, 133(3), 405-8.
8. Zuna RE, Allen RA, Moore WE, et al (2007). Distribution of HPV genotypes in 282 women with cervical lesions: evidence for three categories of intraepithelial lesions based on morphology and HPV type. Mod Pathol, 20(2), 167-74.
9. Park E, Kim JY, Choi S, et al (2019). Car-cinogenic risk of human papillomavirus (HPV) genotypes and potential effects of HPV vaccines in Korea. Sci Rep, 9(1):12556.
10. Agarossi A, Ferrazzi E, Parazzini F, et al (2009). Prevalence and type distribution of high‐risk human papillomavirus infec-tion in women undergoing voluntary cer-vical cancer screening in Italy. J Med Virol, 81(3), 529-35.
11. Arroyo SL, Basaras M, Arrese E, et al (2012). Human papillomavirus (HPV) genotype 18 variants in patients with clin-ical manifestations of HPV-related infec-tions in Bilbao, Spain. Virol J, 9: 258.
12. Krashias G, Koptides D, Christodoulou C (2017). HPV prevalence and type distribu-tion in Cypriot women with cervical cyto-logical abnormalities. BMC Infect Dis, 17(1):346.
13. Delgado D, Marín JM, de Diego J, et al (2012). Human papillomavirus (HPV) genotype distribution in women with ab-normal cervical cytology in the Basque Country, Spain. Enferm Infecc Microbiol Clin, 30(5): 230-5.
14. Meloni A, Pilia R, Campagna M, et al (2014). Prevalence and molecular epidemiology of human papillomavirus infection in Ital-ian women with cervical cytological ab-normalities. J Public Health Res, 3(1):157.
15. Panotopoulou E, Tserkezoglou A, Kouvousi M, et al (2007). Prevalence of human pap-illomavirus types 6, 11, 16, 18, 31, and 33 in a cohort of Greek women. J Med Virol, 79(12): 1898-905.
16. Rassu M, Bertoloni G, Mengoli C, et al (2005). HPV genotype prevalence in cer-vical specimens with abnormal cytology: a report from northeast Italy. Scand J Infect Dis, 37(6-7):476-81.
17. Simanaviciene V, Gudleviciene Z, Popendikyte V, et al (2015). Studies on the prevalence of oncogenic HPV types among Lithuanian women with cervical pathology. J Med Virol, 87(3): 461-71.
18. Spinillo A, Dal Bello B, Gardella B, et al (2009). Multiple human papillomavirus in-fection and high-grade cervical intraepi-thelial neoplasia among women with cy-tological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesions. Gynecol Oncol, 113(1):115-9.
19. Yapijakis C, Adamopoulou M, Antonopou-los G, et al (2008). Prevalence of HPV types in a cohort of Greeks with clinical indication of infection. Anticancer Res, 28(4B):2233-7.
20. He L, He J. (2019). Distribution of high-risk HPV types among women in Sichuan province, China: a cross-sectional study. BMC Infect Dis, 19(1): 390.
21. Bakir A, Alacam S, Karabulut N, et al (2021). Evaluation of human papillomavirus genotype distribution in cervical samples. J Cytol, 38(1):44-49.
22. AYDOĞAN S, YAZGAN A, Emre Erdem TAŞ, et al (2018). The presence and dis-tribution of high-risk HPV types in sim-ultaneous cervical cytology samples. Turk Bull Hyg Exp Biol, 75(1): 13-20.
23. Yan X, Huang Y, Zhang M, et al (2020). Prevalence of human papillomavirus in-fection and type distribution among Uy-ghur females in Xinjiang, northwest Chi-na. Oncol Lett, 20(4):25.
24. Güçkan R, Kılınç Ç, Gözdemir E, et al (2016). Prevalence and distribution of high-risk human papillomavirus in Amasya region, Turkey. Biomed Res, 27(3): 769-72.
25. Pista A, Oliveira A, Verdasca N, et al (2011). Single and multiple human papillomavirus infections in cervical abnormalities in Portuguese women. Clin Microbiol Infect, 17(6): 941-6.
26. Bello BD, Spinillo A, Alberizzi P, et al (2009). Cervical infections by multiple human papillomavirus (HPV) genotypes: preva-lence and impact on the risk of precan-cerous epithelial lesions. J Med Virol, 81(4):703-12.
27. Campos-Romero A, Anderson KS, Longat-to-Filho A, et al (2019). The burden of 14 hr-HPV genotypes in women attending routine cervical cancer screening in 20 states of Mexico: a cross-sectional study. Sci Rep, 9(1):10094.
28. Dursun P, Ayhan A, Mutlu L, et al (2013). HPV Types in Turkey: Multicenter Hospi-tal Based Evaluation of 6388 Patients in Turkish Gynecologic Oncology Group Centers/Türkiye’deki HPV Tipleri: Türk Jinekolojik Onkoloji Grubuna Üye Merkezlere Başvuran 6388 Hastanın Ret-rospektif Analizi. Turk J Pathol, 29(3):210-6.
29. Şahin HÖ, Gürlek B (2019). Distribution of Human Papillomavirus Genotypes and Cervical Cytology Results at A Tertiary Center in The Eastern Black Sea Region of Turkey. Med Sci, 14(4):205-13.
30. Özen S, Çimentepe M, Vardar MA, et al (2018). Anormal Servikal Sitolojili Kadın-larda Human Papillomavirüs Genotiple-rinin Prevalansı. Flora J Infect Dis Clin Mi-crobiol, 23(4): 186-92.
31. Muderris T, Afsar I, Yıldız A, et al (2019). HPV genotype distribution among wom-en with normal and abnormal cervical cy-tology in Turkey. Rev Esp Quimioter, 32(6): 516-524.
32. Demirci M, Guzel AD, Ersahin AA, et al (2019). Human papillomavirus prevalence and genotype distribution among Turkish women with or without cervical lesion. Indian Journal of Medical Microbiology, 36(4): 517-521.
33. Eroglu S, Asgin N. (2020). Frequency and genotype distribution of high-risk human papillomavirus types in Karabuk prov-ince, Turkey: A hospital-based cross-sectional study. Ann Med Res, 27(3):765-9.
34. Coscia MF, Monno R, Ballini A, et al (2015). Human papilloma virus (HPV) genotypes prevalence in a region of South Italy (Apulia). Ann Ist Super Sanita, 51(3):248-51.
35. Gargiulo F, De Francesco MA, Schreiber C, et al (2007). Prevalence and distribution of single and multiple HPV infections in cytologically abnormal cervical samples from Italian women. Virus Res, 125(2):176-82.
36. Robadi IA, Pharaon M, Ducatman BS (2018). The importance of high-risk hu-man papillomavirus types other than 16 and 18 in cervical neoplasia. Arch Pathol Lab Med, 142(6):693-695.
| Files | ||
| Issue | Vol 52 No 3 (2023) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/ijph.v52i3.12144 | |
| Keywords | ||
| Cervical carcinoma Cytology Epithelial abnormality High-risk human papillomavirus Type prevalence | ||
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How to Cite
1.
Erkinüresin T, Kartal E, Üstünyurt E, Demirci H, Kilitçi A, Önal B. Prevalence of High-Risk Human Papillomavirus Types and Their Association with Cervical Squamous Cell Carcinoma, and High- and Low-Grade Squamous Intraepithelial Lesions in Turkish Women. Iran J Public Health. 2023;52(3):612-621.
