Abstract
BackgroundCervical cancer (CC) is the leading cause of morbidity and mortality from cancer in Nepalese women. Nearly all cases of CC are caused by infection with certain genotypes of human papillomavirus (HPV). Data on HPV genotype distribution in Nepalese CC patients is sparse. We aimed to determine the distribution of HPV genotypes in biopsies of CC tissue from Nepalese women.MethodsThis study examined 248 archived paraffin-embedded tissue specimens from CC cases from patients of B.P. Koirala Memorial Cancer Hospital, Bharatpur, Chitwan, Nepal. DNA was extracted from the biopsies and HPV detection performed by PCR. HPV genotyping was then carried out by a reverse line hybridization technique capable of identifying 36 distinct HPV genotypes.ResultsMost of the samples were from tumors that had been designated by hospital pathologists as squamous cell carcinoma (77.6%). 165 of the 248 samples contained DNA of sufficient quality for rigorous PCR testing. All the analyzable specimens were positive for HPV. The most common HPV genotypes, in decreasing order of frequency were 16, 18, 45, 33, 52, 56 and 31; most were found as single infections (94.5%). Together, HPV types 16, 18, and 45 were found in 92% of the tumor samples.ConclusionThis study strengthens the knowledge-base of HPV genotype distribution in CC cases in Nepal. Hopefully, this information will be useful to the medical community and public health policy-makers in generating improved HPV-surveillance, −prevention and -treatment strategies in Nepal.
Highlights
Cervical cancer (CC) is the leading cause of morbidity and mortality from cancer in Nepalese women
This study increases our knowledge of human papillomavirus (HPV) genotype distribution in cervical cancer cases from Nepal
In anticipation that Nepal will soon implement more effective widespread public health measures to prevent HPV infections and their sequelas, CC, it is important to have epidemiologic data regarding the prevalence of HPV genotypes
Summary
Cervical cancer (CC) is the leading cause of morbidity and mortality from cancer in Nepalese women. Most cases of CC are caused by infection with certain genotypes of human papillomavirus (HPV). Data on HPV genotype distribution in Nepalese CC patients is sparse. We aimed to determine the distribution of HPV genotypes in biopsies of CC tissue from Nepalese women. HPV is recognized as the etiologic agent causing almost all invasive CC and a major carcinogen causing other human malignancies as well, including vulvovaginal, oropharyngeal, penile, and anal cancers [2]. Infection with some of the genotypes can cause benign genital warts while others cause precursor cervical lesions, cervical intraepithelial neoplasia (CIN) and CC [4]. Of the 40, at least 12 HPV genotypes have been definitively associated with progression of CIN to CC and are considered carcinogenic to humans [5]. HPV genotypes 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, and 59 are classified as carcinogenic to humans (Group 1; often referred to as high-risk, HR), HPV-68 as probably carcinogenic to humans (Group 2A), HPV-types 26, 30, 34, 53, 66, 67, 69, 70, 73, 82, 85 and 97 (Group 2B) as possibly
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