Introduction/Background Cervical cancer is the most common gynecologic cancer in worldwide with an incidence of 13,1/100.00 and has a high mortality rate of 6,9/100.000. High-risk human papilloma virüs (HPV) is the main cause of cervical squamous intraepithelial lesions and invasive cervical cancer. HPV 16 and HPV 18 are the most leading types in cervical cancer and cervical neoplasms. Some studies found a significant effect of other high-risk HPV types on cervical carsinogenesis some found non-significant. The effect on cervical carsinogenesis of co-infections with other high risk HPV types remains unclear. The purpose of this study is to evoluate the influence risk of cervical carsinogenesis of the other high risk HPV types.
Methodology From January 2016 to May 2020, patients who screened with cotest (pap smear and HPV DNA) and had a high risk HPV DNA positivity underwent a colposcopic analyses and biopsy enrolled the study. Patients evoluated from A Gynaecologic Oncologist or a trained fellow of Gynaecologic Oncology at department of Gynecologic Oncology of Ankara University Faculty of medicine. Patients who have a high risk HPV positivity, age between 25–65 and non vaccinated for HPV included in the study. The exclusion criteries were pregnant paitients, age <25 and >65, treated before for cervical intraepitelial neoplasia, missing medical records, radiation therapy and total hysterectomy history.
Results Table 1 summarizes the demographic data of the patients.CIN2+ results are seen mostly at HPV 16 group ( n=60, 36,4%) then respectively nonHPV 16/18 ( n=40, 24,2%), HPV 18 ( n= 36,21,8%), non 16/18+16/18 (n=29, 17,6%) group. CIN 2+ results was found in 44,2% (n= 73), 35,8% (n=59), 12,7% (n=21), 7,3% ( n=12) of patients with NILM, HSIL,ASCUS and LSIL respectively. Postmenopausal status taken as a reference; a significant difference was observed in premenopausal patients (OR= 2,688, 95% CI = 1,494–4,836 ). Gravidity and number of colposcopic biopsy had a statistically significant effect on CIN2+ results (OR= 1,155, 95% CI=1,006–1,326, OR= 1,964, 95% CI= 1,531–2,519). nonHPV16/18 had taken as a reference the other HPV groups had a statistically significant effect on CIN2+ results, HPV 16 (OR = 3,099,95% CI = 1,933–4,968), HPV 18 (OR= 4,834, 95% CI=2,715–8,608), nonHPV16/18+HPV16/18 ( OR=3,324, 95% CI= 1,851–5,969). The most effective variable on CIN2+ results is endocervical curettage (OR= 28,571,95% CI=17,355–47,037). The effect of cytology results ASCUS had taken as reference value, NILM and LSIL had no significant effect ( p=0,759 and p= 0,553 respectively). HSIL had a statistically significant effect on results (OR= 17,325, 95% CI=7,883–38,077). Table 2 shows HPV genotypes and association of <CIN2 and CIN2+ results.
Conclusion Almost fifty percent of HPV 18 and nonHPV16/18+HPV16/18 types are associated with CIN2+ lesions. Non16/18 HPV types are associated with a 17% percent of CIN2+ lesions. According to cytology results 44,2% of patients have negative cytology and non16/18 HPV types have 42,5% percent of negative cytology. So non16/18 HPV types are not mostly associated with high grade lesions but detected high lesions are mostly associated with negative cytology.
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