Indian Journal of Pathology and Microbiology

LETTER TO EDITOR
Year
: 2012  |  Volume : 55  |  Issue : 4  |  Page : 594--595

High-risk HPV-16 DNA testing after treatment for carcinoma cervix


Veena Kashyap, Suresh Hedau 
 Department of Cytopathology, Molecular Oncology Institute of Cytology and Preventive Oncology, Noida, India

Correspondence Address:
Veena Kashyap
Department of Cytopathology, Institute of Cytology and Preventive Oncology, I-7, Sector-39, Noida
India




How to cite this article:
Kashyap V, Hedau S. High-risk HPV-16 DNA testing after treatment for carcinoma cervix.Indian J Pathol Microbiol 2012;55:594-595


How to cite this URL:
Kashyap V, Hedau S. High-risk HPV-16 DNA testing after treatment for carcinoma cervix. Indian J Pathol Microbiol [serial online] 2012 [cited 2020 Oct 24 ];55:594-595
Available from: https://www.ijpmonline.org/text.asp?2012/55/4/594/107842


Full Text

Sir,

Human papillomavirus (HPV) is the most common sexually transmitted disease in women and persistent infection with oncogenic subtypes of HPV is the necessary cause of cervical cancer. Prevalence of HPV DNA of one or more than 20 genital types has been reported in 90-100% cervical cancer and HPV 16 and 18 are the most frequently detected types in cervical cancers. [1],[2] Carcinoma of the cervix showed a high frequency (98%) of HPV in India as compared to those reported from other parts of the world. HPV 16 is the type exclusively (80-90%) prevalent in cervical cancer. [3] It is evident from the studies that HPV-16 type positive tumors are more differentiated than HPV 18 type positive tumors. There is no cure for HPV causing changes to cervical cancer except hysterectomy with/or radiotherapy or chemotherapy treatment. The cancer patients, who underwent hysterectomy/treatment for cervical cancer, visit the hospital for routine follow-up checkup through smear examination. The aim of the study was to determine the status of HR-HPV16 after hysterectomy and in treated cases of cervical cancer.

For the present report, Pap smears and cervical scrapes for HPV-DNA test, from 30 patients of treated cases of cervical cancer were collected on their latest visit to the Gynecology outpatient department of the hospital where the patients visited for their follow-up check-up after hysterectomy or after treatment of cervical cancer in past years of their life. The follow-up period varied from 2 to 5 year after hysterectomy and/or completion of treatment for cervical cancer. Only adequate and satisfactory samples for both the tests were included in this study. Pap smears were stained by the Pap stain and screened for the cytological findings while cervical scrapes were collected in chilled phosphate buffer saline (PBS) and stored in −20°C and further processed for HPV-DNA analysis. [4] For controls, 20 samples (Pap smear and cervical scrapes) from the patients who underwent hysterectomy due to benign conditions of the uterus, mainly uterine fibroids, were collected and subjected for cytology and HPV-DNA testing.

The mean age of the 30 cervical cancer patients was 45 years (range 26-58 years) and 6 were postmenopausal. Clinically 15(30%) cases were of cancer stage IB, 5 (16.6%) of stage IIB and 10 (33.3%) of stage IIIB. The parity was 2 in 19 patients, 3 in 6 patients, 4 in 3 patients and 5 in 2 patients. Before treatment 25 / 30 (83.3%) cases were positive for HPV 16 and five were negative. After treatment 14/30 cases were cytologically diagnosed as normal means 'No malignant cells present', 10 cases showed inflammation and 7 cases showed malignant cells where cells were spindle-shaped, hyperchromatic nucleus, increased N/C ratio. DNA extracted from cervical scrapes of all the cases were positive for p53 and six samples showed positivity for HPV L1 and HPV 16 genotypes of which 2/15 (13.3%) cases were of stage IB, 1/5 (20%) of stage IIB and 3/10 (33.3%) cases were of stage IIIB. The correlation between cytology and HPV-DNA 16 types was found in 6/7 (85.7%) cases; however, in one case cytology was positive but case was negative for HPV 16 which could be positive for any other type [Table 1]. Smears from controls were diagnosed as normal smears. The extracted DNA from all the scrapes from the controls was positive for p53 but none was positive for HPV 16. These results suggest that HPV 16 DNA type was not eradicated in 6/30 (20%) cases after treatment of carcinoma cervix which is in agreement with report of Chatterjee et al. [5], however, percentage is comparative low in this study. It is also evident from these results that in low-resource setting the smear testing, after hysterectomy or treatment with radiotherapy and chemotherapy, is helpful to predict the condition of vault/cervix; however, the positivity of HPV 16 genotypes suggest the recurrence/new cancer of the organ.{Table 1}

References

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2Zur Hausen H. Viruses in human cancers. Science 1991;254:1167-73.
3Das BC, Hussain S, Nasare V, Bhardwaj M. Prospects and prejudices of human papillomavirus vaccines in India. Vaccine 2008;26:2669-79.
4Kashyap V, Hedau S, Bhambhani S. Defining the validity of classical and non-classical cellular changes indicative of low-grade squamous intraepithelial lesion encompassing human papillomavirus infection in relation to human papillomavirus deoxyribonucleic acid testing. J Cytol 2011;28:159-64.
5Chatterjee R, Mandal B, Bandhopadhyay S. Detection of HPV DNA in cervical carcinomas after treatment in India. Int J Hum Genet 2005;5:27-31.