1. Clinical and virological risk factors involved in premalignant and malignant lesions of the uterine cervix – particular features in Romanian patients.
- Author
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Dudea-Simon, Marina, Berindan-Neagoe, Ioana, Pop, Laura Ancuţa, Ciortea, R., Măluţan, A., Diculescu, D., Vesa, S., Oancea, Mihaela, Nicula, Renata, Mocan-Hognogi, R., Porumb, C., and Mihu, D.
- Subjects
CERVIX uteri ,PRECANCEROUS conditions ,GYNECOLOGIC examination ,CERVIX uteri tumors ,MIXED infections ,LOBULAR carcinoma ,CERVICAL cancer - Abstract
Introduction/objectives. Romania ranks first regarding the incidence and mortality of cervical cancer (CC) in the European Union. The persistent infection with high-risk HPV subtypes is a confirmed precursor in the development of almost all invasive cervical cancers, with HPV 16 and HPV 18 being classically considered the most common oncogenic subtypes. The prevalence of various HPV strains varies widely across the globe. The objectives of this study were to determine the presence of HPV infection and the infectious viral subtype in patients with normal cervix, CIN and with cervical cancer hospitalized in our institution, as well as to evaluate the particularities of this infection according to certain clinical parameters, in order to prioritize the screening services for patients with high-risk characteristics for HPVinduced disease in our geographic region. Materials and method. A total of 77 patients admitted to the “Dominic Stanca” Clinic of Obstetrics and Gynecology, Cluj-Napoca, were enrolled in the study, grouped in three categories: Group 1 – Control (n=38), Group 2 – CIN (n=30), Group 3 – CC (n=9). For all patients, the diagnosis of the cervical condition was confirmed by histopathological examination. A complex clinical database was developed, followed by the detection of high-risk HPV strains by the HPV Genotypes 14 Real-TM Quant kit. The number of previous cyto-tumoral examinations, as well as the macroscopic appearance of the cervix at the gynecologic examination were also recorded. The SPSS v. 24.0 program was used for data analysis, considering the statistical significance at the standard level of 5%. Results. HPV infection was detected in 88.3% of the subjects and a large number of patients were coinfected with several HPV strains. The most prevalent HR strains were HPV 16, 58, 56, 52, 33 and 31. Considering a single examination, 42% of patients in the control group had abnormal cytological results (PAP III, PAP IV), probably in association with the presence of the HPV infection; however, all patients (100%) in CIN and CC groups had abnormal cytology. At the clinical examination, 26.3% of patients without neoplastic cellular changes had a cervix presenting a macroscopic lesion. When analyzing the appearance of the cervix according to the HPV status, it was found that almost half (44.11%) of the patients with microscopically normal cervix had HPV infection, in 96.8% of cases the detected strain being HPV 16. Conclusions. This study highlighted HPV 16, 58, 56 and 52 as the most prevalent strains in the analyzed population. Given the wide variability in the prevalence of HPV-HR strains by geographical area, it is important to include the most common genotypes in the test kits for each region. The appearance of a cervical lesion is associated in half of the cases with HPV 16 infection, in case of normal cytology. HPV testing could bring additional benefits in guiding the subsequent management for these patients. [ABSTRACT FROM AUTHOR]
- Published
- 2022