The importance of HPV testing in cervical cancer prevention
Sažetak
Introduction: Cervical cancer is second most common malignant tumor of female reproductive system in the world. HPV infection is present in 99% of cases, therefore very important in its development.
Material and method: Our research was conducted in Primary health care center for women in Podgorica and included 100 women aged 20-60. During the examination PAP testing and colposcopy were performed to every participant. HPV mRNA detection test with differentiation of types 16, 18, 31, 35, 55 was done in cases of abnormal PAP test result, or suspected clinical or colposcopic examination accompanied by normal PAP test.
Results: PAP testing showed II group in 72 patients, IIIa in 19 and IIIb in 3. HPV testing was performed in 26 patients (in which 4 with PAP II result). It was positive for presence of high-oncogenic types in 15 patients (57,69%) and negative in 11 (42,31%). In patients with detected lesion by examination or colposcopy, we performed biopsy. Results showed CIN I in 1 patient, CIN II in 2, CIN III in 5 and invasive carcinoma in 1 patient.
Conclusion: Our research showed great importance of HPV testing in patients with false negative PAP tests; its importance as diagnostic marker in prognosis of illness, as well as the fact that HPV testing, as basic one, without examination and PAP testing, doesn’t make sense as it would increase the number of false negative results.
Reference
Antonishyn NA , Horsman GB , Kelln RA , Severini A. Human papillomavirus typing and viral gene expression analysis for the triage of women with abnormal results from Papanicolaou test smears to colposcopy. Arch Pathol Lab Med. 2009; 133(10): 1577-86
Subramanya D, Grivas PD. HPV and cervical cancer: updates on an established relationship. Postgrad Med. 2008; 120(4): 7-13
Silverloo I, Andrae B, Wilander E. Value of high-risk HPV-DNA testing in the triage of ASCUS. Acta Obstet Gynecol Scand. 2009; 88(9): 1006-10
Bhatla N, Moda N. The clinical utility of HPV DNA testing in cervical cancer screening strategies. Indian J Med Res. 2009; 130(3):261-5.
Chelmow D, Waxman A, Cain JM, Lawrence HC III. The evolution of cervical screening and the specialty of obstetrics and gynecology. Obstet Gynecol 2012; 119: 695-9.
Berrington de Gonzalez A, Green J, International Collaboration of Epidemiological Studies of Cervical Cancer. Comparison of risk factors for invasive squamous cell carcinoma and adenocarcinoma of the cervix: collaborative reanalysis of individual data on 8,097 women with squamous cell carcinoma and 1,374 women with adenocarcinoma from 12 epidemiological studies. Int J Cancer 2007; 120: 885–91
Munoz N, Bosch FX, de Sanjose S, Herrero R, Castellsague X, Shah KV, Snijders PJ, Meijer CJ, International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 2003; 348: 518–27.
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Munoz N. Human Papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189: 12–9.
Adamopolou M, Kalkani E, Charvalos E, Avgoustidis D, Haidopoulos D, Yapijakis C. Comparison of citology, colposcopy, HPV typing and biomarker analysis in cervical neoplasia. Anticancer Res. 2009; 29: 3401-3410.
Saslow D, Solomon D, Lawson H, Killackey M, Kulasingam S, et al. American Cancer Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the prevention and early detection of cervical cancer. CA Cancer J Clin 2012; 62: 147-172.
De Sanjose S, quint WG, Alemany et al. retrospective international survey and HPV time trends study group. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010; 11: 1048-1056.
Bosch FX, Burchell AN, Schiffman M, Giuliano AR, de Sanjose S, Bruni L, Tortolero-Luna G, Kjaer SK, Munoz N. Epidemiology and natural history of human papillomavirus infections and type-specific implications in cervical neoplasia. Vaccine. 2008; 26 (Suppl): K1–16.
Cuzick J, Clavel C. Petry KU et al. Overview of the Europian and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer 2006; 119: 1095-1101.
Ronco G, Giorgi Rossi P, Carozzi F et al. New technologies for cervical cancer screening (NTCC) working group. Efficacy of human papillomavirus testing for the detection of invasive cervical cancers and cervical intraepithelial neoplasia: a randomized controlled trial. Lancet Oncol 2010; 11: 249-257.
Mayrand MH, Duarte-Franco E, Rodrigues I et al. Canadian cervical cancer screening trial study group. Human papillomavirus DNA versus Papanicolaou screening tests for cervical cancer. N ENGL J Med 2007; 357: 1579-1588.
Anttila A, Kotaniemi-Talonen L, Leinonen M et al. Rate of cervical cancer, severe intraepithelial neoplasia and adenocarcinoma in situ in primary HPV DNA screening with cytology triage: randomized study within organized screening programme. BMJ. 2010; 340: c1804
Castle PE, Stoler MH, Wright TC Jr, Sharma A et al. Performance of carcinogenic human papillomavirus (HPV) testing and HPV16 or HPV18 genotyping for cervical cancer screening of women aged 25 years and older: a subanalysis of the ATHENA study. Lancet Oncol. 2011; 12: 880-890.
Naucler P, Ryd W, Tornberg S et al. Human papillomavirus and Papanicolaou test to screen for cervical cancer. N Engl J Med 2007; 357: 1589-1597.
Bulkmans NW, Berkof J, Rozendal L, et al. Human papillomavirus DNA testing for the detection of cervical intraepithelial neoplasia grade 3 and cancer: 5-year follow-up of a randomized controlled implementation trial. Lancet 2007; 370: 1764-1772.
Plummer M, Schiffman M, Castle PE, Maucort-Boulch D, Wesler CM. ALTS group. A 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion. J infect Dis. 2007; 195: 1582-1589
Rodriguez AC, Schiffman M, Herrero R et al. Rapid slearence of human papillomavirus and implications for clinical focus on persistent infections. J Natl Cancer Inst. 2008; 100: 513-517.
Castle PE, Schiffman M, Wheeler CM, Solomon D. evidence for frequent regression of cervical intraepithelial neoplasia – grade 2. Obstet Gynecol. 2009; 113: 18-25;
Castle PE, Stoler MH, Solomon D, Schiffman M. the relationship of community biopsy-diagnosed cervical intraepithelial neoplasia grade – 2 to the quality control pathology – reviewed diagnoses: an ALTS report. Am J Clin Pathol. 2007; 127: 805-815.
Trimble CL, Piantadosi S, Gravitt P et al. Spontaneous regression of high-grade cervical dysplasia: effects of human papillomavirus type and HLA phenotype. Clin Cancer Res. 2005; 11: 4717-4723.
Nishino HT, Tambouret RH, Wilbour DC. Testing for human papillomavirus in cervical cancer screening. Cancer cytopathology
Schiffman M, Castle PE, Jeronimo J, Rodriguez AC, Wacholder S. Human papillomavirus and cervical cancer. Lancet. 2007; 370: 890-907.
Stanley M. Immune responses to human papillomavirus. Vaccine. 2006; 24 (suppl 1): S16-S22.
Woodman CB, Collins SI, Young LS. The natural history of cervical HPV infection: unresolved issues. Nat Rev Cancer. 2007; 7: 11-22.
Kinney WK, Manos MM, Hurley LB and Ransley JE. Where is the high-grade cervical neoplasia? The importance of minimally abnormal Papanicolaou diagnoses. Obstet Gynecol. 1998; 91: 973-976.
Wright TC, Jr, Cox JT, Massad LS, Carlson J, Twiggs LB and Wilkinson EJ. 2001 consensus guidelines for the management of women with cervical intraepithelial neoplasia. Am J Obstet Gynecol 2003; 189: 295-304.
Monsonego J, Bosch FX, Coursaget P, Cox JT, Franco E, FrazerI, Sankaranarayanan R, Schiller J, Singer A, Wright TC Jr, Kinney W, Meijer CJ, Linder J, McGougan E and Meijer C. Cervical cancer control, properties and new directions. Int J Cancer 2004; 108: 329-333.
Follen Mitchell M, Schottenfeld D, Tortolero-Luna G, Cantor SB and Richards-Korturn R. Colposcopy for the diagnosis of squamous intraepithelial lesions: a meta-analysis. Obstet Gynecol 1998; 91: 626-631.
Huntington J, Oliver LM, St Anna L and Hill J: What is the best approach for patient with ASCUS detected on Pap smear? J Fam Pract 2004; 53: 240-241.
Hatch KD, Schneider A and Abdel-Nour MW: An evaluation of human papillomavirus testing for intermediate and high-risk types as triage before colposcopy. Am J Obstet Gynecol 1995; 172: 1150-1157.
Rijkaart DC, Berkhof J, Rozendaal L, van Kemenade FJ, Bulkmans NW, Heideman DA, Kenter GG, Cuzick J, Snijders PJ, Meijer CJ. Human papillomavirus testing for the detection of high-grade cervical intraepithelial neoplasia and cancer: final results of the POBASCAM randomised controlled trial.
Pajtler M, Milicić-Juhas V, Milojković M, Topolovec Z, Curzik D, Mihaljević I. Assessment of HPV DNA test value in management women with cytological findings of ASC-US, CIN1 and CIN2. Coll Antropol. 2010; 34(1):81-6.
Arbyn M, Sasieni P, Meijer CJ, Clavel C, Kollopoulos G, Dillner J. Chapter 9: Clinical aplications of HPV testing: a summary of meta-analyses. Vaccine. 2006; 24 (suppl 3): S3/78-89
Cox JT, Castle PE, Behrens CM, et al. Comparison of cervical cancer screening strategies incorporating different combinations of cytology, HPV testing, and genotyping for HPV 16/18: results from the ATHENA HPV study. Am J Obstet Gynecol 2013; 208: 184.e1-11.
Leinonen M, Nieminen P, Kotaniemi-Talonen L, et al. Age-specific evaluation of primary human papillomavirus screening vs conventional cytology in a randomized setting. J Natl Cancer Inst 2009; 101: 1612-23.
Kim JJ, Wright TC, Goldie SJ. Cost-effectiveness of alternative triage strategies for atypical squamous cells of undetermined significance. JAMA 2002; 287: 2382-90.
Kim JJ, Wright TC, Goldie SJ. Cost-effectiveness of human papillomavirus DNA testing in the United Kingdom, The Netherlands, France, and Italy. J Natl Cancer Inst 2005; 97: 888-95.
Kulasingam SL, Kim JJ, Lawrence WF, et al. Cost-effectiveness analysis based on the atypical squamous cells of undetermined significance/low-grade squamous intraepithelial lesion Triage Study (ALTS). J Natl Cancer Inst 2006; 98: 92-100.
Ronco G, Segnan N, Giorgi-Rossi P, Zappa M, Casadei GP, Carozzi F, et al. New Technologies for Cervical Cancer Working Group. Human papillomavirus testing and liquid-based cytology: results at recruitment from the new technologies for cervical cancer randomized controlled trial. J Natl Cancer Inst. 2006; 98: 765-74.
Kitchener HC, Almonte M, Thomson C, Wheeler P, Sargent A, Stoykova B, et al. HPV testing in combination with liquid-based cytology in primary cervical screening (ARTISTIC): a randomised controlled trial. Lancet Oncol. 2009; 10: 672-82.
- Autori zadržavaju autorska prava i pružaju časopisu pravo prvog objavljivanja rada i licenciraju ga Creative Commons Attribution licencom koja omogućava drugima da dele rad, uz uslov navođenja autorstva i izvornog objavljivanja u ovom časopisu.
- Autori mogu izraditi zasebne, ugovorne aranžmane za neekskluzivnu distribuciju rada objavljenog u časopisu (npr. postavljanje u institucionalni repozitorijum ili objavljivanje u knjizi), uz navođenje da je rad izvorno objavljen u ovom časopisu.
- Autorima je dozvoljeno i podstiču se da postave objavljeni rad onlajn (npr. u institucionalni repozitorijum ili na svoju internet stranicu) pre ili tokom postupka prijave rukopisa, s obzirom da takav postupak može voditi produktivnoj razmeni ideja i ranijoj i većoj citiranosti objavljenog rada (Vidi Efekte otvorenog pristupa).