HPV Prevalence and Risk of Premalignant and Malignant Lesions in Women with Asymptomatic Cervical Erosion: A Populatıon-Based Study

Yıl 2023, Cilt: 12 Sayı: 3, 207 - 212, 29.12.2023

Pelin Oyardı , Funda Dağıstanlı , Merve Ecem Albayrak , Mehmet Kayhan , Mustafa Ayhan Ekici

https://doi.org/10.47493/abantmedj.1365241

Öz

Objective: To evaluate the prevalence of Human papillomavirus (HPV) and the risk of cervical premalignant and malignant diseases in women with cervical erosion.
Materials and Methods: The results of 32649 women who screened for cervical cancer between January 2014 and December 2019 were retrospectively analyzed. We compared the results of HPV-positive and HPV-negative women with cervical erosion using the Kruskal-Wallis test and Chi-square test.
Results: Of the 32649 women who had cervical cancer screening, 2566 had cervical erosion, and 1585 (4.85%) had HPV positivity. HPV was found positive in 126 (4.91%) women with cervical erosion, and no significant difference in the incidence of HPV positivity in asymptomatic women with and without cervical erosion (p=0.112). As in the general population, in women with cervical erosions, HPV-16 and HPV-18 were found to be the most common. Abnormal cervical cytology was found in 217 (0.72%) women without cervical erosion and 31 (1.21%) women with cervical erosion, which was significantly higher than in women without cervical erosion (p=0.045). There was no significant difference between those with and without cervical erosion in terms of cervical intraepithelial neoplasia (CIN)-1, CIN-2, CIN-3, low-grade squamous intraepithelial lesions, high-grade squamous intraepithelial lesions, in situ cancer, and total abnormal cervical pathology results.
Conclusion: The incidence of HPV and the likelihood of cervical pathology in asymptomatic women with cervical erosion do not differ from the general population.

Anahtar Kelimeler

Cervical erosion, Ectropion, Cervical canser, HPV, CIN

Servikal Erozyonu Olan Hastalarda HPV Prevalansı ve Premalign Malign Lezyon Riski: Populasyon Bazlı Çalışma

Öz

Amaç: Servikal erozyonu olan hastalarda HPV’nin prevalansı ve servikal premalign ve malign hastalık riskini araştırmayı amaçladık.
Gereç ve Yöntemler: Ocak 2014-Ocak 2019 tarihleri arasında serviks kanseri taraması yapılan 32649 hastanın HPV testi ve smear sonuçları retrospektif olarak incelendi. Servikal erozyonu olan HPV pozitif v HPV negatif olan kadınların sonuçları karşılaştırıldı. Gruplar arasındaki verilerin karşılaştırılmasında Kruskal-Wallis testi ve Ki-kare testi kullanıldı.
Bulgular: Serviks kanseri taraması yapılan 32649 kadının 2566’sında servikal erozyon, 1585’inde(%4,85) HPV pozitifliği vardı. Servikal erozyonu olan 126 (%4,91) kadında HPV pozitif olarak saptandı. Asemptomatik servikal erozyonu olan ve olmayan kadınlarda HPV pozitifliği görülme sıklığında anlamlı bir fark yoktu (p=0,112). Genel popülasyonda olduğu gibi servikal erozyonu olann kadınlarda yaygın olarak HPV 16 ve 18’in saptandığı görüldü. Servikal erozyonu olmayan kadınların 217’sinde (%0,72) ve servikal erozyonu olan kadınların 31’inde (%1,21) anormal servikal sitoloji saptandı ve bu oran servikal erozyonu olmayan kadınlara göre anlamlı derecede yüksekti (p=0,045). Cervical İntraepitelial neopplasia (CIN)-1, CIN-2, CIN-3, low-grade squamous intraepithelial lesion, high-grade squamous intraepithelial lesion, İn situ kanser ve toplam anormal servikal sitoloji patoloji sonuçları karşılaştırıldığında servikal erozyonu olanlar ve olmayanlar arasında anlamlı bir fark yoktu.
Sonuç: Servikal erozyonu olan Asemptomatik kadınlarda HPV görülme sıklığı ve servikal patoloji görülme olasılığı genel popülasyondan farklı değildir.

Anahtar Kelimeler

Servikal erozyon, Ektropiyon, Servikal kanser, HPV, CIN

Kaynakça

• Goldacre MJ, Loudon N, Watt B, Grant G, Loudon JD, McPherson K, vd. Epidemiology and clinical significance of cervical erosion in women attending a family planning clinic. Br Med J. 25 Mart 1978;1(6115):748-50.
• Hua X, Zeng Y, Zhang R, Wang H, Diao J, Zhang P. Using platelet-rich plasma for the treatment of symptomatic cervical ectopy. Int J Gynaecol Obstet Off Organ Int Fed Gynaecol Obstet. Ekim 2012;119(1):26-9.
• Hwang LY, Ma Y, Shiboski SC, Farhat S, Jonte J, Moscicki AB. Active squamous metaplasia of the cervical epithelium is associated with subsequent acquisition of human papillomavirus 16 infections among healthy young women. J Infect Dis. 15 Ağustos 2012;206(4):504-11.
• Bright PL, Norris Turner A, Morrison CS, Wong EL, Kwok C, Yacobson I, vd. Hormonal contraception and area of cervical ectopy: a longitudinal assessment. Contraception. Kasım 2011;84(5):512-9.
• Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. Kasım 2018;68(6):394-424.
• Casey PM, Long ME, Marnach ML. Abnormal cervical appearance: what to do, when to worry? Mayo Clin Proc. Şubat 2011;86(2):147-50; quiz 151.
• Patil P, Sharma P. Colposcopic evaluation of cervical erosion in symptomatic women. Int J Reprod Contracept Obstet Gynecol. 25 Mayıs 2017;6(6):2207.
• Ryndock EJ, Meyers C. A risk for non-sexual transmission of human papillomavirus? Expert Rev Anti Infect Ther. Ekim 2014;12(10):1165-70.
• Li N, Franceschi S, Howell-Jones R, Snijders PJF, Clifford GM. Human papillomavirus type distribution in 30,848 invasive cervical cancers worldwide: Variation by geographical region, histological type and year of publication. Int J Cancer. 15 Şubat 2011;128(4):927-35.
• Crow JM. HPV: The global burden. Nature. Ağustos 2012;488(7413):S2-3.
• Sarkar PK, Steele PRM. Routine colposcopy prior to treatment of cervical ectopy: Is it worthwhile? J Obstet Gynaecol. Ocak 1996;16(2):96-7.
• Bangal VB, Patil NA, Gavhane SP, Shinde KK. Colposcopy Guided Management of Cervical Erosions in Rural Population. Sch J Appl Med Sci SJAMS. 2014;261-5.
• Monroy OL, Aguilar C, Lizano M, Cruz-Talonia F, Cruz RM, Rocha-Zavaleta L. Prevalence of human papillomavirus genotypes, and mucosal IgA anti-viral responses in women with cervical ectopy. J Clin Virol. Ocak 2010;47(1):43-8.
• Bayram A, Erkılıç S, Balat Ö, Ekşi F, Uğur MG, Öztürk E, vd. Prevalence and genotype distribution of human papillomavirus in non-neoplastic cervical tissue lesion: cervical erosion. J Med Virol. Kasım 2011;83(11):1997-2003.
• Castle PE, Jeronimo J, Schiffman M, Herrero R, Rodríguez AC, Bratti MC, vd. Age-Related Changes of the Cervix Influence Human Papillomavirus Type Distribution. Cancer Res. 15 Ocak 2006;66(2):1218-24.
• Serindag SR, Topcuoglu MA, Ekici MA, Cetin C. The role of performing a routine four-quadrant cervical biopsy in patients with negative colposcopic findings in increasing the identification rate of cervical intraepithelial neoplasms. Exp Biomed Res. 01 Temmuz 2019;2(3):111-20.