Abstract
BackgroundWe studied anal specimens to determine the distribution of human papillomavirus (HPV) genotypes and co-infection occurrence. This information will contribute to the knowledge of HPV genotype distributions and provide an estimate of the prevalence of different oncogenic HPV genotypes found in patients in Madrid (Spain).MethodsWe studied a total of 82 anal biopsies from the Hospital General Universitario Gregorio Marañón of Madrid. These included 4 specimens with benign lesions, 52 specimens with low-grade anal squamous intraepithelial lesion, 24 specimens with high-grade anal squamous intraepithelial lesions and 2 specimens with invasive anal carcinoma. HPV genotyping was performed with PCR amplification and reverse dot blot hybridization.ResultsWe detected 33 different HPV genotypes, including 16 HPVs associated with a high risk of carcinogenesis, 3 HPVs associated with a highly likely risk of carcinogenesis and 14 HPVs associated with a low-risk of carcinogenesis. In two specimens, an uncharacterized HPV genotype was detected. The most frequent HPV genotypes found were HPV-16 (10.3%; 95% CI: 6.6%-15.1%), HPV-52 (8.5%; 95% CI: 5.2%-13%) and HPV-43/44 (7.6%; 95% CI: 4.5%-11.9%). HPV-18 was only detected in 0.9% (95% CI: 0.1%-3.2%) of the total viruses detected in all lesions. HPV co-infections were found in 83.9% of all types of lesions. The majority of cases (90.2%) were concomitantly infected with the human immunodeficiency virus (HIV).ConclusionThe prevalence of high-risk carcinogenic genotypes in anal pathological samples was remarkable. Therefore, further studies that include a greater number of samples, particularly invasive carcinoma cases are needed to evaluate the potential influence of these HPV genotypes in the appearance of anal carcinomas. Also, the influence of other accompanying infections should be evaluated clarify the appearance of this type of carcinoma.Virtual slidesThe virtual slide(s) for this article can be found here: http://www.diagnosticpathology.diagnomx.eu/vs/2075238024106058.
Highlights
Anal squamous cell carcinoma is an uncommon tumour
A recent systematic review showed that 72% of anal invasive carcinomas were associated with the oncogenic subtypes, human papillomavirus (HPV)-16 and HPV-18
Some authors hold that the analysis of anal cytology for HPV may lead to an overestimation of genotype-specific associations with dysplasia [22]; given the multifocal characteristics of these lesions, we chose this procedure, because of it provided the ability to sample the entire anal canal and surface
Summary
Anal squamous cell carcinoma is an uncommon tumour It is the most common type of cancer malignancy that arises from the anal margin. In the last 25 years, its incidence has increased in Spain, as in other Western countries This increased frequency has been attributed to different factors, including increases in human papillomavirus (HPV) infections and other sexually-transmitted infections, the pandemic of human immunodeficiency virus (HIV) and the increasingly common practice of anal intercourse, in both homosexual and heterosexual settings [3,4,5,6]. We studied anal specimens to determine the distribution of human papillomavirus (HPV) genotypes and co-infection occurrence This information will contribute to the knowledge of HPV genotype distributions and provide an estimate of the prevalence of different oncogenic HPV genotypes found in patients in Madrid (Spain)
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