HPV-specific risk assessment of cervical cytological abnormalities

Background Cytology and HPV genotype screening play an important role in cervical cancer detection. Whether multiple HPV genotyping can predict cytological lesions remains to be further studied. Methods Two thousand two hundred twenty-four females were analyzed for cytology and HPV genotypes test. The possibility of predicting cytological lesions by HPV genotypes test was evaluated by multivariate logistic regression and area under the receiver operator characteristic curve (AUC). Result Abnormal cytological results were found in 479 participants. A total of 688 patients were detected with HPV infection, 619 with HR-HPV infection and 112 with LR-HRV infection. HPV-52 was found to be the most common type among these patients, and a relatively higher risk of cervical lesions was found in HPV positive females. HPV-16, 31, 33 and 58 were found to have significantly higher infection rates in patients with HSIL and higher lesions. The prediction model was developed based on age and HPV-specific genotypes, with the AUC of 0.73 for cytological abnormalities and 0.82 for HSIL and higher lesions. Conclusion HPV-16, 31, 33 and 58 infection are significant risk factors for cervical lesions. Combined HPV genotypes test can effectively predict cytological abnormalities.

ASSESSMENT OF CERVICAL CYTOMORPHOLOGICAL CHANGES IN INFERTILE WOMEN

Background: Assessment of cervical cytomorphological changes in infertile women. Methods: The hospital based prospective study was conducted on 50 women of reproductive age group who were in the follicular phase of their cycle and had primary and secondary infertility Results: On pap smear 80.00% patients were present NILM, 12.00% patients were present ASC-US, 4.00% patients were present inflammatory and 2.00% patients were present HSIL & LSIL. Conclusion: We observed that infertile patients, may benefit from cervical cytological screening as they show a higher tendency for cervical cytological abnormalities. Keywords: ASC-US, HSIL, LSIL.

HPV16 Load Is a Potential Biomarker to Predict Risk of High-Grade Cervical Lesions in High-Risk HPV-Infected Women: A Large Longitudinal French Hospital-Based Cohort Study

High-risk HPV (hrHPV) testing has been implemented as a primary screening tool for cervical cancer in numerous countries. However, there is still a need for relevant triage strategies to manage hrHPV positive women to avoid excessive referral to colposcopy. The objective of this study was to assess, in women infected by hrHPV and presenting no or mild cytological abnormalities, HPV16 and HPV18 viral loads to predict the development of cervical high-grade lesion. Among 2102 women positive for hrHPV, 885 had no lesion or mild cytological abnormalities at baseline and had at least one follow-up (FU) visit. HPV16 and HPV18 prevalence was 25.9% and 8.4%, respectively. Of those women, 15% developed a high-grade lesion during the FU. An HPV16 viral load cut-off set at 3.2 log10GE/103 cells permitted to identify a subgroup of women at high risk of developing high-grade cervical lesion (HR = 2.67; 95% CI 1.80–3.97; p ≤ 0.0001). No specific HPV18 viral load threshold could have been defined in regard to the present study. In multivariate analysis, HPV16 load (absence/log10GE/103 cells < 3.2 vs. ≥3.2), RLU/PC 239 (1–100 pg/mL vs. >100 pg/mL) and cytology (normal vs abnormal) were independently associated with a significant increased risk of high-grade lesion development and were used to construct the prognostic score. In conclusion, HPV16 load is a relevant biomarker to identify women at high risk for developing cervical precancerous lesions.

Evaluation of HPV-Related Biomarkers in Anal Cytological Samples from HIV-Uninfected and HIV-Infected MSM

Men who have sex with men (MSM) harbor the highest risk for anal carcinoma, mainly caused by Human Papillomavirus (HPV). The use of HPV-related biomarkers in the screening for this neoplasia is still debated. We assessed the association between high-risk (hr)HPV DNA, HPV16/18 DNA, hrHPV E6/E7 mRNA, and p16/Ki-67 with cytological abnormalities (any grade) and high-grade intraepithelial lesions (HSIL) in HIV-uninfected and HIV-infected MSM. Overall, 150 cytological samples in PreservCyt (Hologic), with a negative to HSIL report, were analyzed for hrHPV DNA, hrHPV E6/E7 mRNA, and p16/Ki-67 using the Linear Array (Roche), Aptima (Hologic), and CINtec® PLUS (Roche) assays. In HIV-infected MSM, positivity for all the biomarkers significantly increased with the cytological grade. In both populations, the association of hrHPV E6/E7 mRNA and p16/Ki-67 positivity with HPV16 did not differ significantly compared to hrHPVs other than HPV16. In HIV-uninfected MSM, the odds of having an HSIL increased approximately six times for the p16/Ki-67 positive cases. In HIV-infected individuals, all the biomarkers showed a significant association with HSIL, except for hrHPV DNA, with the strongest association observed for p16/Ki-67. The odds of HSIL increased almost 21 times in those positive for this biomarker. Our results encourage further investigation on the use of p16/Ki-67 dual staining in anal cancer screening for HIV-uninfected and HIV-infected MSM.

Risk factors modulating the course of low-grade squamous intraepithelial lesions in women of reproductive age

Background. Infection with oncogenic types of human papillomavirus (HPV) is the leading cause of cervical cancer and its immediate precursors – squamous intraepithelial lesions. However, the persistence of HPV may not be sufficient for the occurrence of malignant transformation, and there may be other exogenous or endogenous factors that, in combination with the virus, increase the risk of developing and progressing cervical neoplasia.Objective: identification of risk factors that modulate the course of low-grade squamous intraepithelial lesions (LSIL) in women of reproductive age.Materials and methods. In 110 women aged 18 to 45 years with a diagnosis of LSIL, we evaluated the impact of risk factors (sexual behavior, reproductive function, contraceptive methods, smoking, HPV infection) on the course of the process (recovery, persistence or progression) during the 12-month follow-up period. HPV testing was performed by real-time PCR.Results. The average age of the study participants was 31.55 ± 7.17 years. Our observations showed that frequent artificial abortions, the practice of risky sexual behavior (early sexual debut, frequent change of sexual partners) increased the risk of persistence and progression of mild cervical cytological abnormalities. The use of oral contraceptives, barrier contraception and smoking did not affect the outcome of the disease.The prevalence of HPV among women with LSIL was 70.91 % (78/110). The predominant types were HPV 16 (35.45 %), HPV 33 (12.73 %) and HPV 18 (12.73 %). HPV 16 was more common in the progression group (62.50 %) than in the regression and persistence groups (14.63 % and 43.40 %, p <0.05). Progression of neoplasias was more often observed in patients with signs of multiinfection of the cervical epithelium with HPV. Single HPV infection was higher in the group of recovered women.Conclusions. The study found that a large number of induced abortions, the practice of risky sexual behavior, the presence of HPV type 16 and multiple HPV infection are factors contributing to the persistence of LSIL and progression to HSIL. These data may be useful for the management of women with mild cervical cytological abnormalities.

Comparison of cervical cancer screening by self-sampling papillomavirus test versus pap-smear in underprivileged women in France

Background The purpose of this study was to compare cervical cancer screening by pap smear (PS) versus preliminary HPV testing based on self-collected samples (SC-HPV). Methods Interventional study among underprivileged women from 25 to 65 years old in four French cities. The control group (CG) was referred for a PS. The experimental group (EG) conducted a SC-HPV test followed by a PS in case of positivity. Differences on screening completion and cytological abnormalities were analysed by logistic and Cox regression. Results 383 women were assigned to the EG and 304 to the CG. The screening completion proportion was 39.5% in the CG compared to 71.3% in the EG (HR = 2.48 (CI 95% [1.99–3.08]; p < 0.001). The proportion of cytological abnormalities was 2.0% in the CG and 2.3% in the EG (OR = 1.20 (CI 95% [0.42–3.40]; p = 0.7). The proportion of participants lost to follow-up was 60.5% in the CG and 63.2% in the EG HPV positive (p = 0.18). Conclusion Providing an SC-HPV-test increased the participation of underprivileged women in CCS. Nevertheless, the significant number of lost to follow-up in both groups can undermine the initial benefits of the strategy for HPV positive women. Registration: Clinicaltrials.gov: NCT03118258.