Med Bull Sisli Etfal Hosp. 2021; 55(2): 232-236 | DOI: 10.14744/SEMB.2021.67355

Human Papilloma Virus Frequency and Genotypes; Evaluation of the 4879 Screenings Made with Polymerase Chain Reaction and Chip Array Between 2001 and 2019 in Istanbul

Gurcan Vural¹, Nedim Polat^2
1Department of Pathology, Okan University Hospital, Istanbul, Turkey
²Department of Pathology, Beykent University Faculty of Medicine, Istanbul, Turkey

Objectives: The aim of this study is the documentation of human papilloma virus (HPV) frequency and types seen in the city of Istanbul, Turkey, as well as evaluation of the relationship between these subtypes and cytological and pathological diagnoses.
Methods: 4879 cases were studied in our molecular pathology department between 2001 and 2019 in Istanbul. Between 2001 and 2010, 1692 cases were screened for HPV 6, 11, 16, 18, 31, and 33 by conventional hybridization and polymerase chain reaction (PCR). Since 2011, up to 49 HPV typing has been performed for 3187 cases with chip array. The cases were referred to the pathology center and the hospital pathology department by clinicians for screening before HPV vaccination and on the observation of precancerous changes and koilocyts in cytological-histopathological evaluations.
Results: In this study, the frequency of HPV was found to be 10.8% (527 HPV-positive cases). Among these, 348 cases were high-risk groups, whether or not they were previously associated with a low-risk group. When we look at the distribution of the cases according to the high-risk HPV types, HPV 16 is the most common type. The frequencies of occurrence of other HPV types are as following: HPV–16: 41.7%, HPV–31: 11.7%, HPV–52: 7.9%, HPV–51: 7.1%, HPV–33: 6.9%, HPV–45: 6.5%, HPV–18: 6.3%, HPV–39: 6.1%, and HPV–58: 5.8%. It was further found that multiple infections were 28% of high grade squamous intraepithelial lesion cases. HPV frequency was 38% and 72%, respectively, in cases with cytologically or histopathological precancerous, low-grade squamous intraepithelial lesion, and HSIL changes. As a final note, HPV was detected in 9 of 10 cases with cervical cancer (90%). Only 1 adenocarcinoma case detected in the series was a double infection with HPV types 18 and 45.
Conclusion: HPV 16 was the most common type found in this study. It is followed by types 31, 52, 51, 33, 45, 18, 39, and 58, respectively. The most common association observed in double infections was between HPV 16 and 58. It was also observed that the incidence of HPV in the city of Istanbul, Turkey, was similar to other developed countries. As a final note, in addition to screening tests, PCR and chip array studies should be conducted and the community should be informed about preventive medicine and the importance of condom use.

Keywords: Cervical cancer, chip array; epidemiology; genotype; human papilloma virus; polymerase chain reaction.

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Serviksin prekanseröz ve malign lezyonlarinda human papilloma virus sikliði ve genotipleri; Ýstanbul’da 2001 -2019 yillari arasinda PCR ve chip array ile yapilan 4879 taramanin deðerlendirmesi

Gurcan Vural¹, Nedim Polat^2
1Okan Üniversitesi Hastanesi Patoloji Bölümü, Ýstanbul
²Beykent üniversitesi Týp Fakültesi Patoloji Aanabilim Dalý, Ýstanbul

Amaç: Türkiye’de Ýstanbul’da HPV (Human Papilloma Virüs) sýklýðý ve tiplerinin dokümante edilmesi yanýsýra, saptanan bu alt tipler ve sitolojik ve patolojik tanýlarýn iliþkisinin deðerlendirilmesi.
Gereçler ve Yöntem: Ýstanbul’da 2001-2019 yýllarý arasýnda moleküler patoloji departmanýmýzda 4879 olgu çalýþýlmýþtýr. 2001-2010 arasýnda 1692 olgu klasik hibridizasyon ve PCR (polimeraz zincir reaksiyonu) ile HPV 6,11,16,18, 33 için taranmýþtýr. 2011 yýlýndan itibaren chip array ile günümüzde kýrkdokuza varan HPV tiplemesi 3187 olgu için yapýlmýþtýr. Olgular sitolojik-histopatolojik deðerlendirmelerde prekanseröz deðiþiklik ve koilosit görülmesi üzerine veya tarama amacýyla ya da HPV aþýlamasý öncesi klinisyenler tarafýndan patoloji merkezine ve hastane patoloji departmanýna yönlendirilmiþtir.
Bulgular: Bu çalýþmada HPV sýklýðý %10,8 olarak saptanmýþtýr (527 HPV-pozitif olgu). Bunlar içinde 348 olgu beraberinde düþük riskli grup olsun ya da olmasýn yüksek riskli gruptur. Olgularýn yüksek riskli HPV tiplerine göre daðýlýmýna baktýðýmýzda HPV 16 (%41,7), HPV 31 (%11.7), HPV 52 (%7.9), HPV 51 (%7.1), HPV 33 (%6.9), HPV 45 (%6.5), HPV 18 (%6.3), HPV 39 (%6.1) ve HPV 58 (%5.8) olarak belirlenmiþtir. HSIL (yüksek dereceli skuamöz epiteliçi lezyon) olgularýnda çoklu enfeksiyon sýklýðý %28’dir. Sitolojik ya da histopatolojik olarak prekanseröz, LSIL (düþük dereceli skuamöz epiteliçi lezyon) ve HSIL deðiþiklik gösteren olgularda HPV sýklýðý sýrasý ile %38 ve %72’dir. Servikal kanser saptanan 10 olgunun 9’unda HPV saptanmýþtýr (%90).
Sonuç: Çalýþmada en sýk HPV 16 saptanmýþtýr. Onu sýrasý ile HPV 31, 52, 51, 33, 45, 18, 39 ve 58 takip etmektedir. Çift enfeksiyonlarda gözlenen en sýk birliktelik HPV 16 ve 58 arasýnda olmuþtur. Ýstanbul’da HPV sýklýðýnýn geliþmiþ ülkelerden çok farklý olmadýðýný görülmektedir. Tarama testleri, PCR ve chip array çalýþmalarý yaný sýra toplum koruyucu hekimlik açýsýndan bilgilendirilmeli, prezervatif kullanýmýnýn önemi vurgulanmalýdýr (SETB-2021-01-022).

Anahtar Kelimeler: HPV, Genotip; PCR; Epidemiyoloji, Servikal Kanser; Chip Array

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