Evaluation of cytomorphology, HPV status and HPV 16 genotype in the outcome prediction of ASCUS and LSIL cervical cytology

Autor: Vrdoljak-Mozetič, Danijela, Štemberger-Papić, Snježana, Verša Ostojić, Damjana, Rubeša-Mihaljević, Roberta, Dinter, Morana, Brnčić-Fischer, Alemka, Krašević, Maja
Jazyk: chorvatština
Rok vydání: 2016
Předmět:
Zdroj: Medicina Fluminensis : Medicina Fluminensis
Volume 52
Issue 3
ISSN: 0025-7729
Popis: Cilj: Istražiti međusobnu povezanost i prognostički značaj HPV statusa (humani papiloma-virus), HPV 16 genotipa i citomorfologije kod pacijentica s citološkim nalazom abnormalnih stanica pločastog epitela vrata maternice graničnog i blagog stupnja. Materijali i metode: U studiju su uključene pacijentice s inicijalnim citološkim nalazom vrata maternice atipičnih skvamoznih stanica neodređenog značenja (ASCUS, N = 160) i skvamozne intraepitelne lezije niskog stupnja (LSIL, N = 155). Analizirane su citomorfološke osobine koilocitoze, parakeratoze i makrocitoze. Sve pacijentice testirane su pomoću grupnog visokorizičnog HPV DNA testa (hybrid capture 2), a za pozitivne nalaze određen je genotip HPV-a pomoću molekularne metode INNO-LiPA HPV Genotyping v2. Pacijentice su praćene prosječno 26 mjeseci pomoću citologije, kolposkopije i patohistologije te je zabilježena regresija, stagnacija ili progresija bolesti. Rezultati: Najzastupljeniji HPV genotip je HPV 16. Nađen je kod 27,9 % ASCUS-a (N = 29) i u 16,5 % LSIL-a (N = 16), a njegova učestalost značajno je veća kod žena mlađih od 30 godina (P < 0,001). Makrocitoza se češće nalazi kod HR HPV negativnog ASCUS-a i LSIL-a (P < 0,05). Koilocitoza i parakeratoza nisu pokazale značajne razlike u odnosu na HR HPV status. U grupi LSIL odsutnost koilocitoze znatno je češća kod HPV 16 genotipa u odnosu na HPV ne-16 genotip (P = 0,002). Parakeratoza se češće nađe u HPV ne-16 grupi, ali razlika je statistički značajna samo kod LSIL-a (P = 0,005). Nepovoljan ishod bolesti zabilježen je u 25,3 % slučajeva ASCUS-a i 13,8 % LSIL-a. Progresija bolesti statistički je značajno povezana uz HR HPV pozitivitet (P < 0,001) i prisutnost HPV 16 genotipa (P < 0,001). Prisutnost koilocitoze, parakeratoze i makrocitoze u grupama ASCUS i LSIL nije povezana s nepovoljnim ishodom bolesti. Zaključak: U citološkim nalazima ASCUS i LSIL HPV 16 najčešće je nađeni genotip, a povezan je s češćom odsutnošću koilocitoze i parakeratoze. Nepovoljan ishod bolesti značajno je češći kod HR HPV i HPV 16 pozitivnih slučajeva, dok citomorfološke osobine koilocitoze, parakeratoze i makrocitoze nisu povezane s nepovoljnim ishodom bolesti. Ovi rezultati mogu pridonijeti optimiziranju praćenja i obrade pacijentica s inicijalnim citološkim nalazima ASCUS i LSIL te utjecati na moguće modifikacije usvojenih kliničkih i citoloških smjernica za lezije vrata maternice.
Objective: To analyse characteristics and prognostic value of HPV status (human papilloma virus), HPV 16 genotype and cytomorphology in the patients with cervical cytology finding of borderline and mild abnormalities of squamous epithelium. Material and methods: Patients with initial cytology finding of atypical squamous cells of undetermined significance (ASCUS, N = 160) and low-grade squamous intraepithelial lesion (LSIL, N = 155) were included. Cytomorphological characteristics of koilocytosis, parakeratosis and macrocytosis were analysed. In all patients HPV DNA test was performed using high risk probe of hybrid capture 2 test. In positive samples additional HPV genotyping was doneusing INNO-LiPA HPV Genotyping v2 assay. Patients were followed by cytology, colposcopy and histology for average of 26 months. Three possible clinical outcomes: regression, stagnation or progression were recorded. Results: The most frequent HPV genotype was HPV 16 and it was found in 27.9% ASCUS (N = 29) and in 16.5% LSIL (N = 16) cases. It was found more frequently in women under 30 years of age (P < 0.001). Macrocytosis was more frequent finding in HR HPV negative cases in ASCUS and LSIL (P < 0.05). Koilocytosis and parakeratosis did not show relationship with HR HPV status. When analysed according to HPV genotype, in LSIL, koilocytosis was more frequent finding in HPV non-16 genotype compared to HPV 16 genotype (P=0.002). Parakeratosis is more frequently found in HPV non-16 genotype cases, but statistically significant difference is found only in LSIL (P = 0.005). Unfavourable disease outcome was recorded in 25.3% of ASCUS and 13.8% LSIL. Disease progression was associated with HR HPV positivity (P < 0.001) and HPV 16 genotype (P < 0.001). Presence of koilocytosis, parakeratosis and macrocytosis are not associated with the unfavourable disease outcome in ASCUS and LSIL. Conclusion: HPV 16 was the most frequent genotype in ASCUS and LSIL and it is more frequently associated with koilocytosis and parakeratosis absence. HR HPV DNA positivity and HPV 16 genotype were associated with the disease progression in ASCUS and LSIL. Cytomorphology features showed no association with the unfavourable disease outcome. These results could help in optimising follow up and management of patients with initial cytology diagnosis of ASCUS and LSIL and have possible impact on used guidelines for cervical abnormalities.
Databáze: OpenAIRE
Externí odkaz: