Abstract
Squamous cervical carcinoma (SCC) is the most common cancer found in Mexican women. Human papillomavirus (HPV) infection is a prerequisite for this disease. In Mexico little is known about the prevalence of HPV-types and knowledge of the circulating genotypes by region is limited. The aim of this study was to determine the prevalence and genotypes of HPV in biopsies from women with intraepithelial lesions and SCC. A total of 211 cervical biopsies were studied. Histopathological analysis was done and HPV DNA was detected by PCR using MY09/MY11 (MY-PCR) and GP5+/GP6+ (GP+PCR) primers. Viral type was determined by RFLP's or sequencing. Tissues were classified as low-grade squamous intraepithelial lesion (LSIL) in 123 cases, high-grade squamous intraepithelial lesion (HSL) in 40 and SCC in 48. Prevalence of HPV was 55.3% in LSIL, 65% in HSIL and 91.7% in SCC by MY-PCR. These percentages increased to 83, 77.5 and 100%, respectively, when HPV-negative samples were analyzed by GP+PCR. In 138 of 211 samples (65.4%), HPV was detected by MY-PCR and 43 (20.4%) were positive by GP+PCR. In 166 (91.7%) of 181 infections high risk HPV-types were found. Twelve genotypes were detected (16, 18, 31, 33, 45, 52, 58, 59, 61, 66, 70, 81). Prevalence of HPV 16 in LSIL, HSIL and SCC, were 70.6, 54.8 and 70.8%, respectively and it was the most common type in all cases (67.9%). A significantly higher number of positive samples were detected with MY-PCR and GP+PCR. The high prevalence of HPV infection with high-risk types, especially HPV16, among Mexican women with SIL and SCC, has important implications in the treatment and prophylaxis.
Highlights
181 (85.8 %) were human papillomavirus (HPV) positive by one or both polymerase chain reaction (PCR) methods and the prevalence of infection by diagnosis was of 100% for squamous cervical carcinoma (SCC), 77.5% for HSIL and 83% for low-grade squamous intraepithelial lesions (LSIL)
In our study we found a prevalence of 65.4% of HPV in all biopsies and were detected using the MY09/11 primers set but the percentage varied from 55.3 in LSIL, to 65 in HSIL and 91.7 in SCC
In LSIL and SCC the percentage was higher than that recently reported by other authors, who used the same primers, but the prevalence of HPV found in HSIL was lower than that [9, 11]
Summary
Infection with high oncogenic risk types of human papillomavirus (HPV), especially types 16 and 18, has been established as a necessary cause for the development of squamous cervical carcinoma (SCC) and its premalignant lesions (squamous intraepithelial lesions, SIL)[1,2,3,4].Walboomers et al, in 1999 conducted a worldwide study reporting that 99.7% of tissues with cervical carcinoma contained HPV DNA percentage varied from 93 to 99.7%, depending on the primers used for the PCR[1,5,6].In Mexico, SCC is the main cause of death by cancer in women over 25 and in Guerrero State the women experience a higher mortality rates by this disease compared with women who live in other states[7,8]. Infection with high oncogenic risk types of human papillomavirus (HPV), especially types 16 and 18, has been established as a necessary cause for the development of squamous cervical carcinoma (SCC) and its premalignant lesions (squamous intraepithelial lesions, SIL)[1,2,3,4]. Walboomers et al, in 1999 conducted a worldwide study reporting that 99.7% of tissues with cervical carcinoma contained HPV DNA percentage varied from 93 to 99.7%, depending on the primers used for the PCR[1,5,6]. Some studies conducted in Mexico report finding HPV DNA in 8.8 to 94.2% of low-grade squamous intraepithelial lesions (LSIL), in 77 to 92% of high- The prevalence of genital HPV infection in the world varies from one region to another [9,10,11,12].
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