HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes

Abstract The world health organization (WHO) called for coordinated global action in 2018 to eliminate cervical cancer, ensuring that every woman is screened and treated for precancerous lesions (World Health Organization. Cervical cancer: an NCD we can overcome. Geneva, 2018. http://www.who.int/dir...

Full description

Bibliographic Details
Main Authors: Mahmoud Abbas, Jan de Jonge, Olaf Bettendorf
Format: Article
Language:English
Published: Nature Portfolio 2022-10-01
Series:Scientific Reports
Online Access:https://doi.org/10.1038/s41598-022-22438-z
_version_ 1811257058407743488
author Mahmoud Abbas
Jan de Jonge
Olaf Bettendorf
author_facet Mahmoud Abbas
Jan de Jonge
Olaf Bettendorf
author_sort Mahmoud Abbas
collection DOAJ
description Abstract The world health organization (WHO) called for coordinated global action in 2018 to eliminate cervical cancer, ensuring that every woman is screened and treated for precancerous lesions (World Health Organization. Cervical cancer: an NCD we can overcome. Geneva, 2018. http://www.who.int/director-general/speeches/detail/cervical-cancer-an-ncd-we-can-overcome.tegy ). Cytology-based screening has been for decades the conventional method of screening. Ancillary techniques have been added like immunocytochemistry with P16/Ki67 and L1-Capsid, but these methods require maintenance of complex infrastructure and highly trained personnel as well as relatively short screening intervals. HPV-based screening method to detect high-risk groups is a faster and automated method, which does not need morphologically highly qualified personal with high social costs. In the study, we have focused on the distribution of cervical lesions in the age groups with concordance of detection HPV high-risk subtypes (HPV-HR) and on the safety of the screening method. In the Institute for Pathology and Cytology-Schuettorf-Leer-Germany 146.800 samples of women from the age of and above 35 years were analyzed between the beginnings of 2020 until the beginning of 2021. 63.710 cases under 35 years old were analyzed. The samples were processed for both conventional cytological techniques and for molecular detection and subtyping of HPV-HR according to the advice and measurements of BD-manufacture. In this study, we have studied the histopathological results (Table 2) after colposcopy according to the age subgroups. The histopathological results were subdivided into no dysplasia, cervical intraepithelial neoplasia I (CIN I), cervical intraepithelial neoplasia II (CIN II), cervical intraepithelial neoplasia III (CIN III), squamous cell carcinoma (Sq.c.c), adenocarcinoma in situ (AIS), endometrial carcinoma, endocervical adenocarcinoma and cases without biopsy during the colposcopy (COB). We have used the muenchener classification III (Table 3) as a subgrading system for the cytological specimens. The frequency of detecting HPV56/59/66 is higher as detecting HPV-16 and HPV18 in age groups under 35 years old, 41–50 years old and 51–60 years old. HPV16 is detected higher in age groups 35–40 years old and above 60 years. The incidence of high squamous intraepithelial lesions (CIN II and III) is 0.92% in age group 35–40 years, 0.54% in age under 35 years, 0.59% in age group 41–50 years old, 0.35% in age group 51–60 years old and 0.15% in age group above 60 years old. There is no significance (p value = 0.4060). Low grade cervical lesions (CIN I) were 0.13% (< 35 Ys), 0.35% (35–40 Ys), 0.36% (41–50 Ys), 0.25% (51–60 Ys) and 0.098% (> 60Y s), which was statistically significant (p value = 0.04,0.60). Without dysplasia 0.19% (< 35 Ys), 0.5% (35–40 Ys), 0.56% (41–50 Ys), 0.51 (51–60 Ys) and 0.26% (> 60 Ys). There is no significance between occurrence of cervical dysplasia and without dysplasia despite of detection of HPV-HR subtypes (p value = 0.1754). The only use of HPV-subtyping is not a secure method and a protective way for women. There are worldwide many HPV-positive cases, which have been psychologically impaired with higher costs, although they have no cervical epithelial changes during the HPV-infection. There are many HPV-negative cases, in some studies up to 13% of cases, which develop cervical cancer. We have the opinion and are convinced that the screening should be both morphologically via cytological examination and may be with adding immunocytochemistry to detect the really dysplastic cervical lesions. HPV-subtyping may be added every three years to detect the concomitant subtype.
first_indexed 2024-04-12T17:50:39Z
format Article
id doaj.art-2c22aa3ef15f4c3792193fc4063e6d1d
institution Directory Open Access Journal
issn 2045-2322
language English
last_indexed 2024-04-12T17:50:39Z
publishDate 2022-10-01
publisher Nature Portfolio
record_format Article
series Scientific Reports
spelling doaj.art-2c22aa3ef15f4c3792193fc4063e6d1d2022-12-22T03:22:30ZengNature PortfolioScientific Reports2045-23222022-10-011211710.1038/s41598-022-22438-zHPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changesMahmoud Abbas0Jan de Jonge1Olaf Bettendorf2Gerhard-Domagk Institute for Pathology-University Muenster-GermanyInstitute for Pathology and Cytology (IPN)-Schuettorf-GermanyInstitute for Pathology and Cytology (IPN)-Schuettorf-GermanyAbstract The world health organization (WHO) called for coordinated global action in 2018 to eliminate cervical cancer, ensuring that every woman is screened and treated for precancerous lesions (World Health Organization. Cervical cancer: an NCD we can overcome. Geneva, 2018. http://www.who.int/director-general/speeches/detail/cervical-cancer-an-ncd-we-can-overcome.tegy ). Cytology-based screening has been for decades the conventional method of screening. Ancillary techniques have been added like immunocytochemistry with P16/Ki67 and L1-Capsid, but these methods require maintenance of complex infrastructure and highly trained personnel as well as relatively short screening intervals. HPV-based screening method to detect high-risk groups is a faster and automated method, which does not need morphologically highly qualified personal with high social costs. In the study, we have focused on the distribution of cervical lesions in the age groups with concordance of detection HPV high-risk subtypes (HPV-HR) and on the safety of the screening method. In the Institute for Pathology and Cytology-Schuettorf-Leer-Germany 146.800 samples of women from the age of and above 35 years were analyzed between the beginnings of 2020 until the beginning of 2021. 63.710 cases under 35 years old were analyzed. The samples were processed for both conventional cytological techniques and for molecular detection and subtyping of HPV-HR according to the advice and measurements of BD-manufacture. In this study, we have studied the histopathological results (Table 2) after colposcopy according to the age subgroups. The histopathological results were subdivided into no dysplasia, cervical intraepithelial neoplasia I (CIN I), cervical intraepithelial neoplasia II (CIN II), cervical intraepithelial neoplasia III (CIN III), squamous cell carcinoma (Sq.c.c), adenocarcinoma in situ (AIS), endometrial carcinoma, endocervical adenocarcinoma and cases without biopsy during the colposcopy (COB). We have used the muenchener classification III (Table 3) as a subgrading system for the cytological specimens. The frequency of detecting HPV56/59/66 is higher as detecting HPV-16 and HPV18 in age groups under 35 years old, 41–50 years old and 51–60 years old. HPV16 is detected higher in age groups 35–40 years old and above 60 years. The incidence of high squamous intraepithelial lesions (CIN II and III) is 0.92% in age group 35–40 years, 0.54% in age under 35 years, 0.59% in age group 41–50 years old, 0.35% in age group 51–60 years old and 0.15% in age group above 60 years old. There is no significance (p value = 0.4060). Low grade cervical lesions (CIN I) were 0.13% (< 35 Ys), 0.35% (35–40 Ys), 0.36% (41–50 Ys), 0.25% (51–60 Ys) and 0.098% (> 60Y s), which was statistically significant (p value = 0.04,0.60). Without dysplasia 0.19% (< 35 Ys), 0.5% (35–40 Ys), 0.56% (41–50 Ys), 0.51 (51–60 Ys) and 0.26% (> 60 Ys). There is no significance between occurrence of cervical dysplasia and without dysplasia despite of detection of HPV-HR subtypes (p value = 0.1754). The only use of HPV-subtyping is not a secure method and a protective way for women. There are worldwide many HPV-positive cases, which have been psychologically impaired with higher costs, although they have no cervical epithelial changes during the HPV-infection. There are many HPV-negative cases, in some studies up to 13% of cases, which develop cervical cancer. We have the opinion and are convinced that the screening should be both morphologically via cytological examination and may be with adding immunocytochemistry to detect the really dysplastic cervical lesions. HPV-subtyping may be added every three years to detect the concomitant subtype.https://doi.org/10.1038/s41598-022-22438-z
spellingShingle Mahmoud Abbas
Jan de Jonge
Olaf Bettendorf
HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
Scientific Reports
title HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
title_full HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
title_fullStr HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
title_full_unstemmed HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
title_short HPV-genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
title_sort hpv genotyping versus conventional cervical cytology as a screening method to detect dysplastic cervical epithelial changes
url https://doi.org/10.1038/s41598-022-22438-z
work_keys_str_mv AT mahmoudabbas hpvgenotypingversusconventionalcervicalcytologyasascreeningmethodtodetectdysplasticcervicalepithelialchanges
AT jandejonge hpvgenotypingversusconventionalcervicalcytologyasascreeningmethodtodetectdysplasticcervicalepithelialchanges
AT olafbettendorf hpvgenotypingversusconventionalcervicalcytologyasascreeningmethodtodetectdysplasticcervicalepithelialchanges