The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study
Abstract Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive,...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2024-03-01
|
| Series: | BMC Infectious Diseases |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12879-024-09166-7 |
| _version_ | 1797233719161913344 |
|---|---|
| author | Patrick Kafui Akakpo Emmanuel Gustav Imbeah Kofi Ulzen-Appiah Afua Darkwa-Abrahams Ernest Adjei Kwabena Amo-Antwi Ernest Obeng Amo Edmund Mounir Der Edwin Kwame Wiredu |
| author_facet | Patrick Kafui Akakpo Emmanuel Gustav Imbeah Kofi Ulzen-Appiah Afua Darkwa-Abrahams Ernest Adjei Kwabena Amo-Antwi Ernest Obeng Amo Edmund Mounir Der Edwin Kwame Wiredu |
| author_sort | Patrick Kafui Akakpo |
| collection | DOAJ |
| description | Abstract Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive, multi-center cross-sectional study with purposive sampling of cases with cervical cancer diagnosed from January 2012 through to December 2018 was employed relying on archived Formalin Fixed Paraffin Embedded (FFPE) tissues from four (4) Teaching Hospitals. Cervical cancers were assessed for histopathological features following WHO guidelines. In addition, the novel Tumour Budding and Nest Size Grade (TBNS) for SCC, SILVA pattern of invasion for EAC and Tumour Infiltrating Lymphocytes (TILs) were assessed. High Risk HPV testing was performed using an isothermal, multiplex nucleic acid amplification method from ATILA biosystem (Mountain View California, USA). The FFPE blocks were tested for 15 hrHPV genotypes. Results were analyzed using SPSS v.26.0, with descriptive statistics and cross-tabulation and chi-square tests done with significance established at p < 0.05. Results A total of 297 cases were identified for the study with ages ranging from 20 to 95 years. The peak age group for cervical cancer was 46 to 55 years. For those tested, hrHPV positivity rate was 85.4% [EAC (84.6%) and SCC (85.6%)]. The top five hrHPV serotypes for both histological cancers were 59 (40.0%), 35 (32.0%), 18 (30.0%), 16 (15.0%), and 33 (10.0%) respectively. Approximately, 58.2% of infections were multiple. Single hrHPV infections were mostly caused by hrHPV 59 (28.9%), and 16 (26.3%). TBNS grade for SCC, SILVA pattern of invasion for EAC and TILs did not show any statistically significant relationship with hrHPV. Conclusion We affirm reported differences in hrHPV types associated with cervical cancer in Ghana with hrHPV types such as 59, 35, and 33 forming a significant proportion of hrHPV types associated with cervical cancer. This difference in hrHPV types should guide vaccine improvement and triaging of hrHPV positives. Though multiple infections are more common, some hrHPV types such as hrHPV 16 and 59 are responsible for most single infections associated with cervical cancer. Simple haematoxylin and eosin-based morphological assessments can improve the prognostication of patients with cervical cancer. |
| first_indexed | 2024-04-24T16:20:38Z |
| format | Article |
| id | doaj.art-1005c683c6894b4cbf7a4e9e6f407f3c |
| institution | Directory Open Access Journal |
| issn | 1471-2334 |
| language | English |
| last_indexed | 2024-04-24T16:20:38Z |
| publishDate | 2024-03-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Infectious Diseases |
| spelling | doaj.art-1005c683c6894b4cbf7a4e9e6f407f3c2024-03-31T11:11:36ZengBMCBMC Infectious Diseases1471-23342024-03-0124111110.1186/s12879-024-09166-7The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional studyPatrick Kafui Akakpo0Emmanuel Gustav Imbeah1Kofi Ulzen-Appiah2Afua Darkwa-Abrahams3Ernest Adjei4Kwabena Amo-Antwi5Ernest Obeng Amo6Edmund Mounir Der7Edwin Kwame Wiredu8Department of Pathology, School of Medical Science, University of Cape Coast / Cape Coast Teaching HospitalDepartment of Pathology, School of Medical Science, University of Cape Coast / Cape Coast Teaching HospitalDepartment of Pathology, School of Medical Science, University of Cape Coast / Cape Coast Teaching HospitalDepartment of Pathology, School of Medicine and Dentistry, University of Ghana/ Korle Bu Teaching HospitalDepartment of Pathology, Komfo-Anokye Teaching HospitalDepartment of Obstetrics and Gynecology, School of Medicine and Dentistry, Kwame Nkrumah University of Science and TechnologyPathologists Without Borders LtdDepartment of Pathology, School of Medical Sciences, University for Development Studies / Tamale Teaching HospitalDepartment of Pathology, School of Medicine and Dentistry, University of Ghana/ Korle Bu Teaching HospitalAbstract Background The burden of cervical cancer in Ghana is high due to a lack of a national screening and vaccination program. Geographical variations in high-risk Human Papilloma Virus incidence and type should be considered for vaccine improvement and screening in LMICs. Methods A descriptive, multi-center cross-sectional study with purposive sampling of cases with cervical cancer diagnosed from January 2012 through to December 2018 was employed relying on archived Formalin Fixed Paraffin Embedded (FFPE) tissues from four (4) Teaching Hospitals. Cervical cancers were assessed for histopathological features following WHO guidelines. In addition, the novel Tumour Budding and Nest Size Grade (TBNS) for SCC, SILVA pattern of invasion for EAC and Tumour Infiltrating Lymphocytes (TILs) were assessed. High Risk HPV testing was performed using an isothermal, multiplex nucleic acid amplification method from ATILA biosystem (Mountain View California, USA). The FFPE blocks were tested for 15 hrHPV genotypes. Results were analyzed using SPSS v.26.0, with descriptive statistics and cross-tabulation and chi-square tests done with significance established at p < 0.05. Results A total of 297 cases were identified for the study with ages ranging from 20 to 95 years. The peak age group for cervical cancer was 46 to 55 years. For those tested, hrHPV positivity rate was 85.4% [EAC (84.6%) and SCC (85.6%)]. The top five hrHPV serotypes for both histological cancers were 59 (40.0%), 35 (32.0%), 18 (30.0%), 16 (15.0%), and 33 (10.0%) respectively. Approximately, 58.2% of infections were multiple. Single hrHPV infections were mostly caused by hrHPV 59 (28.9%), and 16 (26.3%). TBNS grade for SCC, SILVA pattern of invasion for EAC and TILs did not show any statistically significant relationship with hrHPV. Conclusion We affirm reported differences in hrHPV types associated with cervical cancer in Ghana with hrHPV types such as 59, 35, and 33 forming a significant proportion of hrHPV types associated with cervical cancer. This difference in hrHPV types should guide vaccine improvement and triaging of hrHPV positives. Though multiple infections are more common, some hrHPV types such as hrHPV 16 and 59 are responsible for most single infections associated with cervical cancer. Simple haematoxylin and eosin-based morphological assessments can improve the prognostication of patients with cervical cancer.https://doi.org/10.1186/s12879-024-09166-7Cervical cancerHPVSquamous cell carcinomaAdenocarcinomaGhana |
| spellingShingle | Patrick Kafui Akakpo Emmanuel Gustav Imbeah Kofi Ulzen-Appiah Afua Darkwa-Abrahams Ernest Adjei Kwabena Amo-Antwi Ernest Obeng Amo Edmund Mounir Der Edwin Kwame Wiredu The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study BMC Infectious Diseases Cervical cancer HPV Squamous cell carcinoma Adenocarcinoma Ghana |
| title | The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study |
| title_full | The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study |
| title_fullStr | The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study |
| title_full_unstemmed | The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study |
| title_short | The distribution of hrHPV genotypes among cervical cancer cases diagnosed across Ghana: a cross-sectional study |
| title_sort | distribution of hrhpv genotypes among cervical cancer cases diagnosed across ghana a cross sectional study |
| topic | Cervical cancer HPV Squamous cell carcinoma Adenocarcinoma Ghana |
| url | https://doi.org/10.1186/s12879-024-09166-7 |
| work_keys_str_mv | AT patrickkafuiakakpo thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT emmanuelgustavimbeah thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT kofiulzenappiah thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT afuadarkwaabrahams thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT ernestadjei thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT kwabenaamoantwi thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT ernestobengamo thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT edmundmounirder thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT edwinkwamewiredu thedistributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT patrickkafuiakakpo distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT emmanuelgustavimbeah distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT kofiulzenappiah distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT afuadarkwaabrahams distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT ernestadjei distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT kwabenaamoantwi distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT ernestobengamo distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT edmundmounirder distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy AT edwinkwamewiredu distributionofhrhpvgenotypesamongcervicalcancercasesdiagnosedacrossghanaacrosssectionalstudy |