scholarly journals Prognostic Impact of Human Papillomavirus Infection on Cervical Dysplasia, Cancer, and Patient Survival in Saudi Arabia: A 10-Year Retrospective Analysis

Author(s):  
F.S. Alhamlan ◽  
D.A. Obeid ◽  
H.H. Khayat ◽  
A.M. Tulbah ◽  
I.A. Al-Badawi ◽  
...  

AbstractCervical cancer is caused by persistent human papillomavirus (HPV) infection. However, HPV prevalence data and survival rates among HPV-infected women are scare in Saudi Arabia. This study assessed the prevalence of HPV genotypes in a 10 year time-frame. Cervical biopsy specimens underwent HPV detection, HPV viral load using qPCR, HPV genotyping, p16INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates. Of the 316 cervical specimens examined, HPV was detected in 96 (30.4%); 37.3% had cervical cancer; 14.2% cervical intraepithelial neoplasia (CIN) III, 4.1% CIN II, and 17.0% CIN I. A significant association was found between HPV-16 viral load and disease progression (P < .001, Mann-Whitney U) and between HPV presence and cervical cancer (χ2, 56.78; P < .001). The expression of p16INK4a was a significant predictor of survival: women who had p16INK4a overexpression had poorer survival rates (multivariate Cox regression, hazard ratio, 3.2; 95% CI, 1.1-8.8). In addition, multivariate models with HPV status and cervical cancer diagnosis showed that HPV status was a significant predictor of survival: HPV-positive women had better survival rates than HPV-negative women (haza. These findings suggest that implementing cervical cancer and HPV screening programs may decrease cervical cancer rates and improve survival rates of women in Saudi Arabia.

2021 ◽  
Vol 41 (6) ◽  
pp. 350-360
Author(s):  
Fatimah Alhamlan ◽  
Dalia Obeid ◽  
Hadeel Khayat ◽  
Tulbah Asma ◽  
Ismail A. Al-Badawi ◽  
...  

BACKGROUND: Data on human papillomavirus (HPV) prevalence and survival rates among HPV-infected women are scarce in Saudi Arabia. OBJECTIVE: Assess the prevalence of HPV genotypes in cervical biopsy specimens and its effect on survival over a 10-year timeframe. DESIGN: Retrospective, cross-sectional. SETTINGS: Saudi referral hospital. PATIENTS AND METHODS: Cervical biopsy specimens were collected from women aged 23-95 years old who underwent HPV detection, HPV genotyping, p16 INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates. MAIN OUTCOME MEASURES: Survival rate of HPV-positive cervical cancer patients. SAMPLE SIZE: 315 cervical biopsy specimens. RESULTS: HPV was detected in 96 patients (30.4%): 37.3% had cervical cancer; 14.2% cervical intraepithelial neoplasia (CIN) III, 4.1% CIN II, and 17.0% CIN I. A significant association was found between HPV presence and cervical cancer (χ 2 =56.78; P <.001). The expression of p16 INK4a was a significant predictor of survival: women who had p16 INK4a overexpression had poorer survival rates (multivariate Cox regression, hazard ratio, 3.2; 95% CI, 1.1–8.8). In addition, multivariate models with HPV status and cervical cancer diagnosis showed that HPV status was a significant predictor of survival: HPV-positive women had better survival rates than HPV-negative women. CONCLUSION: These findings suggest that implementing cervical and HPV screening programs may decrease cervical cancer rates and improve survival rates of women in Saudi Arabia. LIMITATION: Single center and small sample size. CONFLICT OF INTEREST: None.


2020 ◽  
Vol 26 (18) ◽  
pp. 2073-2086
Author(s):  
Saule Balmagambetova ◽  
Andrea Tinelli ◽  
Ospan A. Mynbaev ◽  
Arip Koyshybaev ◽  
Olzhas Urazayev ◽  
...  

High-risk human papillomavirus strains are widely known to be the causative agents responsible for cervical cancer development. Aggregated damage caused by papillomaviruses solely is estimated in at least 5% of all malignancies of the human body and 16% in cancers that affect the female genital area. Enhanced understanding of the complex issue on how the high extent of carcinogenicity is eventually formed due to the infection by the Papoviridae family would contribute to enhancing current prevention strategies not only towards cervical cancer, but also other HPV associated cancers. This review article is aimed at presenting the key points in two directions: the current cervical cancer prevention and related aspects of HPV behavior. Virtually all applied technologies related to HPV diagnostics and screening programs, such as HPV tests, colposcopy-based tests (VIA/VILI), conventional and liquid-based cytology, currently available are presented. Issues of availability, advantages, and drawbacks of the screening programs, as well as vaccination strategies, are also reviewed in the article based on the analyzed sources. The current point of view regarding HPV is discussed with emphasis on the most problematic aspect of the HPV family concerning the observed increasing number of highly carcinogenic types. Present trends in HPV infection diagnostics throughout the human fluids and tissues are also reported, including the latest novelties in this field, such as HPV assay/self-sample device combinations. Besides, a brief outline of the related prevention issues in Kazakhstan, the leading country of Central Asia, is presented. Kazakhstan, as one of the post-soviet middle-income countries, may serve as an example of the current situation in those terrains, concerning the implementation of globally accepted cervical cancer prevention strategies. Along with positive achievements, such as the development of a nationwide screening program, a range of drawbacks is also analyzed and discussed.


2020 ◽  
Vol 14 (01) ◽  
pp. 97-103
Author(s):  
Fatimah S Alhamlan ◽  
Hadeel H Khayat ◽  
Dalia A Obeid ◽  
Asma M Tulba ◽  
Teejan S Baduwais ◽  
...  

Introduction: Human papillomavirus (HPV) infection is typically critical in the oncogenesis of cervical cancer. However, available HPV detection kits differ in their ability and sensitivity to detect various types of HPV, and this variability has led to inconsistencies in the reporting of the geographic prevalence of HPV types, especially in developing countries. Here, we compared results of the recently developed GenoFlow HPV array test, which detects 33 HPV genotypes, to those of the well-established reverse line blot (RLB) assay, which detects 23 HPV types. Methodology: In total, 608 cervical specimens with cytology results ranging from normal to cancer were collected using an endocervical brush from women attending outpatient clinics in Riyadh, Saudi Arabia. Results: Sixty-nine specimens (11%) were positive for HPV. HPV genotype detection using the GenoFlow test had a sensitivity of 62% and a specificity of 100%. Overall agreement between the two HPV genotyping methods was 97%, with a concordance rate of 95%. Among the GenoFlow test results, 2% indicated additional HPV types that were not detected in the RLB assay, whereas the GenoFlow test missed 0.3% of the HPV types that were detected by the RLB; however, both tests were in agreement in detecting all major HPV types. Conclusion: The GenoFlow test was reliable, with results comparable to the RLB test. However, because the GenoFlow test is less labor-intensive and takes less total time (3 hours), it is a promising, affordable alternative to the RLB for HPV diagnosis and screening programs.


2015 ◽  
Vol 9 (06) ◽  
pp. 571-576 ◽  
Author(s):  
Fatimah Saeed Alhamlan ◽  
Ahmed A Al-Qahtani ◽  
Mohammed N Al-Ahdal

Human papillomavirus (HPV) infection is a significant etiological factor and an important prognosticator in cervical cancer. Indeed, researchers worldwide have confirmed these roles for high-risk HVPs in over 70% of cervical cancer cases. According to the World Health Organization, approximately 561,200 new cancer cases (5.2% of all new cancers) are attributed to HPV infection. Over 120 types of HPV are classified further as either low-risk HPV (LR-HPV) or high-risk HPV (HR-HPV) based on their oncological potential of transforming cells. The LR-HPV types cause benign hyperproliferative lesions (i.e. genital warts) while the HR-HPV types are strongly associated with premalignant and malignant cervical lesions. Data on the prevalence of HPV, survival of infected patients, and mortality rate are scarce in Saudi Arabia. The unsubstantiated assumption of a low prevalence of HPV in Saudi Arabia has contributed to limiting HPV research in this conservative country. Therefore, the goal of this review is to shed light on the current HPV research being conducted and the prevalence of HPV in Saudi Arabia.


2019 ◽  
Vol 47 (12) ◽  
pp. 6171-6181 ◽  
Author(s):  
Sudong Liu ◽  
Xiaodong Gu ◽  
Ruiqiang Weng ◽  
Jing Liu ◽  
Zhixiong Zhong

Objective To formulate strategies for prevention of cervical cancer, we investigated the prevalence of human papillomavirus (HPV) infection and the age-specific distribution among female participants in southeastern China. Methods From January 2016 to July 2018, 36,871 women from Meizhou People’s Hospital (Huangtang Hospital), Meizhou Hospital Affiliated to Sun Yat-sen University were enrolled in this prospective study. HPV genotypes were detected using Luminex technology. Results HPV infection was observed in 18.34% of the participants, and 79.98% were infected with high-risk HPVs. The five most prevalent genotypes were HPV52 (18.18%), HPV16 (16.06%), HPV58 (11.37%), HPV53 (8.82%), and HPV39 (6.42%). The 9-valent HPV vaccine efficiently reduced the HPV infection rate by more than 10%, which is twofold the rate of other vaccines. Most HPV infections were observed in women age 40 to 49 years, and those age 30 to 59 years accounted for 79.62% of positive patients. Conclusion Our findings regarding HPV genotypes and the age-specific distribution of HPV infection in the study area will contribute to the development of cervical cancer screening programs and vaccine strategies.


2018 ◽  
Author(s):  
Melissa K Frey ◽  
Cathleen E Matrai

Human papillomavirus (HPV) affects the majority of sexually active individuals and accounts for approximately 5% of human cancers and nearly 100% of cervical cancer cases. The progression from persistent HPV infection to invasive cervical cancer takes at least 10 years and is preceded by epithelial dysplastic changes. Cytologic screening programs, which rely on disease detection during this precancerous interval, have successfully decreased the incidence of cervical cancer. The HPV vaccine, approved since 2006, effectively decreases cervical disease but remains underused in the United States and abroad, with the incidence of HPV-related cancers still on the rise. In this review, we discuss the epidemiology and molecular pathogenesis of HPV infections and cervical cancer development, cervical cancer screening and screening terminology, management of abnormal screening results, and HPV vaccination.   This review contains 4 figures, 8 tables and 49 references Key words: atypical squamous cells of undetermined significance, cervical cancer, cervical intraepithelial neoplasia, colposcopy, high-grade cervical dysplasia, human papillomavirus, human papillomavirus vaccine, low-grade cervical dysplasia, Papanicolaou test, papillomaviruses  


2017 ◽  
pp. 51-58
Author(s):  
N.M. Voloshena ◽  
◽  
E.D. Zvantseva ◽  

The problem of early diagnostics and prevention of cervical cancer is actual in Ukraine.The leading etiologic factor in the genesis of cervical neoplasia and a number of other organs is Human papillomavirus (HPV). The human papillomavirus is sexually transmitted and has high contagiosity. Cancer prevention consists in effective screening, early detection and treatment of pathological changes in the cervix. The aggressive treatment of diseases caused by (HPV) has been replaced by a tactic of a differentiated approach, taking into account to the age of the woman and her reproductive plans. The objective: was to study the efficacy and tolerability of the combined use of Proteflazid® systemically in drops form and locally in the form of suppositories for 3 months in patients with cervical intraepithelial neoplasia (CIN) of lung and moderate severity (CIN 1 and CIN 2) associated with the human papillomavirus (HPV); determination on the basis of the results of the need for further destructive treatment. Materials and methods. For the period from July 2016 to September 2017, we examined and treated 86 women with morphologically confirmed intraepithelial neoplasia of the cervix associated with HPV infection. Results. Based on the performed studies, it was found that 6 months after treatment with Proteplasid® systemically and locally for 3 months, regression of CIN was noted in 93% of patients. In all cases, a reduction in viral load of more than 2 Lg of HPV/105, which is a marker of the effectiveness of antiviral therapy, has been recorded. Six months after treatment in 84% of patients and 9 months in 88%, there was complete elimination of HPV or reduced viral load to clinically insignificant values – less than 3 Lg. Conclusion. The drug Proteflazid® suppositories and drops contributes to the elimination of human papillomavirus (HPV) and other viral-bacterial infections and reduces the risk of cervical neoplasia. Key words: cervical cancer, screening, cervical neoplasia, Human papillomavirus, viral-bacterial infections, Proteflazid®.


2013 ◽  
Vol 35 ◽  
pp. 607-613 ◽  
Author(s):  
Mariarosa Pascale ◽  
Danae Pracella ◽  
Renzo Barbazza ◽  
Barbara Marongiu ◽  
Enrico Roggero ◽  
...  

The role of human papillomavirus (HPV) in prostate carcinogenesis is highly controversial: some studies suggest a positive association between HPV infection and an increased risk of prostate cancer (PCa), whereas others do not reveal any correlation. In this study, we investigated the prognostic impact of HPV infection on survival in 150 primary PCa patients. One hundred twelve (74.67%) patients had positive expression of HPV E7 protein, which was evaluated in tumour tissue by immunohistochemistry. DNA analysis on a subset of cases confirmed HPV infection and revealed the presence of genotype 16. In Kaplan-Meier analysis, HPV-positive cancer patients showed worse overall survival (OS) (median 4.59 years) compared to HPV-negative (median 8.24 years,P=0.0381). In multivariate analysis age (P<0.001), Gleason score (P<0.001), nuclear grading (P=0.002), and HPV status (P=0.034) were independent prognostic factors for OS. In our cohort, we observed high prevalence of HPV nuclear E7 oncoprotein and an association between HPV infection and PCa survival. In the debate about the oncogenic activity of HPV in PCa, our results further confirm the need for additional studies to clarify the possible role of HPV in prostate carcinogenesis.


2012 ◽  
Vol 22 (6) ◽  
pp. 1063-1068 ◽  
Author(s):  
Teeraporn Chinchai ◽  
Jira Chansaenroj ◽  
Sukumarn Swangvaree ◽  
Pairoj Junyangdikul ◽  
Yong Poovorawan

Background and ObjectiveCervical cancer is the second most common female genital cancer worldwide. There is strong epidemiological and molecular evidence indicating that human papillomavirus (HPV) infection is a necessary event in the development of cervical intraepithelial lesion and subsequent invasive carcinoma. The aim of this study was to investigate the HPV genotype distribution and prevalence in cervical cancer of Thai women.Materials and MethodsOne hundred fifty-five cervical cancer specimens were enrolled in this study. The HPV genotypes were determined by means of the combined use of a line probe assay (INNO-LiPA) and DNA chip methods.ResultsOf the overall prevalence of HPV in the study group, 83.2% and 11.6% of the cases had single and multiple genotype infections, respectively. The most prevalent genotypes were HPV 16 (51%), followed by HPV 18 (20%), HPV 52 (10.3%), HPV 58 (5.8%), and HPV 33 (4.5%). All HPV genotypes found in this study could be classified as 13 high-risk HPV, 2 low-risk HPV, and 2 additional types. Of the specimens, 94.8% had at least one high-risk HPV genotype infection.ConclusionAs for the potential benefits of commercially available prophylactic vaccines to prevent HPV infection in Thailand, both vaccines (bivalent and quadrivalent) can protect from HPV-related cervical cancer in only approximately 71%. Therefore, screening programs such as routine Papanicolaou test, cytology, and HPV DNA detection are still essential for cervical cancer prevention. Moreover, future generations of HPV vaccines should also include the other most common genotypes and decrease the severe adverse effects reported at the present time.


Author(s):  
Kun Lee ◽  
Jingyi Si ◽  
Ricai Han ◽  
Wei Zhang ◽  
Bingbing Tan ◽  
...  

There are more supports for the view that human papillomavirus (HPV) infection might be an etiological factor in the development of cervical cancer when the association of persistent condylomata is considered. Biopsies from 318 cases with squamous cell carcinoma of uterine cervix, 48 with cervical and vulvar condylomata, 14 with cervical intraepithelial neoplasia (CIN), 34 with chronic cervicitis and 24 normal cervical epithelium were collected from 5 geographic regions of China with different cervical cancer mortalities. All specimens were prepared for Dot blot, Southern blot and in situ DNA-DNA hybridizations by using HPV-11, 16, 18 DNA labelled with 32P and 3H as probes to detect viral homologous sequences in samples. Among them, 32 cases with cervical cancer, 27 with condyloma and 10 normal cervical epitheliums were randomly chosen for comparative EM observation. The results showed that: 1), 192 out of 318 (60.4%) cases of cervical cancer were positive for HPV-16 DNA probe (Table I)


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