Abstract
The aim of the study was to determine the prevalence of human papillomavirus (HPV) types 16, 18, and 45 in women with cervical intraepithelial changes caused by high-risk HPV in relation to colposcopic and histological findings. MATERIAL AND METHODS. A prospective study of 393 women with cervical cytologic changes confirmed by the Papanicolaou test was undertaken from April 3, 2006, to April 3, 2007. The Hybrid Capture 2 assay was performed. HPV-positive women underwent genotyping for types 16, 18, and 45. Colposcopy and biopsy were performed in 317 (80.7%) and 249 women (63.4%), respectively. The results were analyzed by age groups. RESULTS. Of all the women with cervical intraepithelial changes, 59% were positive for HR HPV, and 62% were positive for HPV types 16, 18, and 45. HPV types 16, 18, and 45 were detected in 54.8% of women with ASC-US/AGUS/ASC-H, 50.0% of women with LSIL, and 75.6% of women with HSIL. After confirmation of any histological and colposcopic changes, HPV types 16, 18, and 45 were detected in 68.0% and 69.0% of women, respectively. Moreover, 84.2% of the women with HSIL and high-grade colposcopic changes, and 78.5% of the women with HSIL and CIN 2/CIN 2-3/CIN 3/carcinoma in situ were positive for HPV types 16, 18, and 45. The sensitivity of the Papanicolaou test together with the Hybrid Capture 2 test compared with the Papanicolaou test together with the HPV 16/18/45 test diagnosing CIN 2+ changes did not differ (96.7% vs. 97.1%), but the specificity was higher (40.3% vs. 8.0%). CONCLUSIONS. The majority of the cytologic, colposcopic, and histological changes were caused by HPV types 16, 18, and 45. Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions.
Highlights
Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide [1] with the prevalence of high-risk (HR) HPV in asymptomatic women varying from 2% to 44% [2]
Despite the high prevalence of HPV types 16, 18, and 45, testing for these genotypes together with the Papanicolaou test did not improve the diagnosis of high-grade cervical intraepithelial lesions
177 women (45.0%) who had a Papanicolaou test repeated in Hospital of Lithuanian University of Health Sciences (HLUHS) were positive for HR HPV, and 110 (62.1%) of them were positive for HPV types 16, 18, and 45
Summary
Human papillomavirus (HPV) infection is the most common sexually transmitted disease worldwide [1] with the prevalence of high-risk (HR) HPV in asymptomatic women varying from 2% to 44% [2]. Cervical cancer is the third most common cancer in women worldwide and accounts for 9% of all female cancers [6]. Other HPV-related cancers, such as anal, vulvar, vaginal, penile, and pharyngeal, both in men and women accounts for additional 0.7% of cancers; The mean morbidity from cervical cancer in Lithuania is twice as big as the mean morbidity in the European Union countries (22 vs 10.7 cases per 100 000 women) [8]. The increasing mortality from cervical cancer among young women aged 15–34 years is being observed [11]
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