Association of Cervical Intraepithelial Lesions in Women with Genital Warts; A Cytological and Molecular Study

Background: Cervical cancer is a major health concern worldwide, according to the World Health Organization. It is now the fourth most common cancer after breast, colorectal and lung cancers in women worldwide. It is also the world's third most common cause of cancer death in women. objective of the study is to clarify association between genital warts & cervical intraepithelial lesions using cervical smear cytology with real time PCR. Methods: The study was carried out at The Department of gynecology & dermatology in Tanta University Hospitals. 50 patients were included started from June 2019 to June 2020. Results: From June 2019 to June 2020, 50 married women with genital warts are include in the study. Ten women out of 50 were married twice. Number of pregnancies ranged from 0 to 4 with a median (IQR) of 2.56. As regard LSIL group; 6 patients were infected by low risk HPV genotypes while only 2 patients had a mixed infection with high risk HPV genotypes. While all HSIL patients were infected by high risk HPV genotypes. Conclusions: The cytological characteristics of HPV on cervical smear appear to be non-specific. Therefore, PCR for HPV should be made use of as an adjunct to cervical smears in high risk patients to diagnose and follow up early cervical intraepithelial lesions.

Cervical Intraepithelial Lesions in Women with Persistent Inflammatory Smear on Pap Smear: A Descriptive Cross-sectional Study

Introduction: Persistent inflammatory smear is a benign finding on pap test but is associated with premalignant lesion of the cervix. Further evaluation is therefore necessary. This study was done to determine the prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear. Methods: This is descriptive observational study conducted in Department of Obstetrics and Gynaecology of tertiary care centre of Nepal from 15th May 2020 to 14th May 2021 after obtaining ethical clearance from Institutional Review Board (Reference no MEMG/IRC/338/GA). Women with two consecutive pap smear reports showing inflammatory findings were enrolled. Colposcopy was performed and Modified Reid’s colposcopic index was used to grade the lesions. Colposcopic guided biopsy was taken and tissue sent for histopathology for abnormal colposcopic lesions. Data analysis was done using Statistical Package for Social Sciences version 21 and frequency and percentages were used to present data. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: Among 115 women, 57 (49.5%) at 95% Confidence Interval (40.37-58.63) had Cervical Intraepithelial lesions. Among them 48 (41.7%) had low grade intraepithelial lesions and 9 (7.8%) had high grade lesions on colposcopy. Conclusions: The prevalence of cervical intraepithelial lesions in women with persistent inflammatory smear on pap was higher in our study compared to other studies.

Human Papillomavirus genotypes in cervical intraepithelial lesions among women at two referral centers in Brazil

This study aimed to describe Human Papilloma Virus (HPV) genotypes and women with cervical intraepithelial neoplasia (CIN) sociodemographic characteristics at the oncology reference centers. A secondary data of 325 records on women with CIN were analyzed from a cohort study database conducted in two public institutions in the oncological service in the Northeast of Brazil, from July 2014 to February 2016. The HPV genotype analysis was carried out on 142 through viral DNA sequence after amplifying PCR technique and compared the sequences identified in the GenBank databases. The women were predominantly 25 to 39 years old. The 325 biopsies revealed 17.6% low-grade of cervical intraepithelial lesion (CIN1) and 82.4% high-grade of cervical intraepithelial lesion (CIN2 or CIN3). Among the 142 HPV genotypes the most prevalent was HPV-16 (51.7%), followed by HPV-35 (6.9%) and HPV-45 (6.2%). HPV-18 was in only 2.1%. There was an association between HPV-16 and high-grade lesions (CIN2 or CIN3) (p=0.008). Although HPV-16 was the predominant genotype in cervical intraepithelial lesions, especially high-grade lesions (CIN2 or CIN3), HPV-35 was the second most frequent in high-grade lesions in this population. This suggests that other HPVs may be as prevalent as those commonly known in some regions.

Accuracy of HPV E6/E7 mRNA examination using in situ hybridization in diagnosing cervical intraepithelial lesions

Background The consistency of pathologists in the diagnosis of cervical intraepithelial neoplasia (CINs) is not ideal, especially between low- and high-grade squamous intraepithelial lesions (LSIL and HSIL). This study was aimed to explore efficient strategies for the grading of CINs. Methods The medical records of patients with high risk human papillomavirus (HR-HPV) infections who had underwent cervical biopsy or conization from April 2018 to April 2019 in Beijing Chao-Yang Hospital were collected and examined. The HR-HPV E6/E7 mRNA in the tissues of patients with CINs was detected using RNAscope chromogenic in situ hybridization (RISH). Immunohistochemistry (IHC) was performed to evaluate the expression of p16INK4a (P16) and Ki67. Results HR-HPV E6/E7 mRNA signals were detected in 3/27 (11.1 %) of CIN 1, and in 32/33 (97.0 %) of CIN 2/3. Most of the staining patterns (27/32, 84.4 %) had a full-thickness epithelial layer staining with weak-to-strong nuclear and cytoplasmic dot-like signals in CIN 2/3, and there were also few special staining patterns that were significantly different from the others. A number of indicators were compared between LSIL and HSIL. There were statistically significant differences in E6/E7 mRNA, p16, Ki67 and cytology between the two groups (P < 0.05). According to the logistic regression analysis, merely E6/E7 mRNA positivity was significantly associated with CIN2/3 (OR: 52.53, 95 % CI, P < 0.05). In the detection of CIN 2/3, the sensitivity and specificity of HPV E6/E7 mRNA alone was not significantly inferior to that of its different combinations with Ki67, p16 and cytology (all, P > 0.05). Conclusions RISH is efficient in grading of CINs. The HPV E6/E7 mRNA expression might reflect the phase HPV infections, and its positive pattern might predict the development direction of CINs, providing the possibility to realize more accurate treatments for patients.