HPV genotype determination and E6/E7 mRNA detection for management of HPV positive women

Bruno, Maria Teresa; Ferrara, Martina; Fava, Valentina; Rapisarda, Agnese Maria Chiara; Coco, Angela

doi:10.1186/s12985-018-0957-z

Cited by 33 publications

(29 citation statements)

References 29 publications

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“…Multiple HPV types infections are relevant only in the early stages of the lesion (CIN1-CIN2), while they are absent in carcinoma, where the lesions are only a single type. Also in our study the genotype 16 is the one with the highest oncogenic risk, therefore genotyping is important, to study HPV 16 positive women [20].…”

Section: Resultsmentioning

confidence: 92%

Multiple HPV infection as possible marker of neoplastic progression

Bruno¹,

Scalia²,

Cassaro³

et al. 2020

Preprint

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Background : Some studies in the literature suggest a possible role of multiple HPV infections as a prognostic factor in the development and progression of cervical neoplasia. we studied the cases of single and multiple HPV infection and analyzed the correlation with negative cases, and preneoplastic and neoplastic lesions of the uterine cervix with the aim of making a contribution to the prognostic factor under discussion Methods: 921 women with clinical HPV manifestations were enrolled. Inclusion criteria were: positive at the cytology for HPV lesions, presence of preneoplastic and neoplastic lesions of the uterine cervix diagnosed by the histology examination All the patients underwent colposcopy and cervical biopsy with viral genotyping. The search for viral DNA was carried out using polymerase chain reaction. Genotype 16 is correlated with the majority of CIN2+; we divided the multiple HPV16 infections into “infections with 16 as the first genotype” (16mHPV) (e.g. HPV 16 , 31, 52) and into “ infections containing 16” (m16HPV) (e.g. HPV 31, 16 , 52), we then divided them based on the number of genotypes present: infections with 2 strains, 3 strains, 4 strains, and > 4 strains. Results: We analyzed the differences between single and multiple infections with HPV16, the patients with single infections had a higher incidence of CIN2+ (83.3%) with respect to those with multiple infections (71.4%). The 16mHPV infection was significative for CIN2/CIN3. When the prevalence of the combinations between the genotypes was studied, we found that in 16mHPV infection HPV16, 18 and HPV 16, 31 were the most common combinations of mHPV infection (50%) and the most frequent in CIN2/CIN3 The 16mHPV infection with 2 genotypes, with respect to the infections with 3 or more genotypes, was significative with an OR= 7.94 (IC% 2.55-24.73). Conclusions: Our results suggest that single HPV infections give a higher risk of SCC development with respect to multiple HPV infections. Among multiple infections, only 16mHPV infection with 2 genotypes is associated with CIN2/CIN3 in a significative way and it presents an 8 times greater risk of developing a high grade lesion.

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Section: Resultsmentioning

confidence: 92%

Multiple HPV infection as possible marker of neoplastic progression

Bruno¹,

Scalia²,

Cassaro³

et al. 2020

Preprint

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“…Not with standing the limits of the retrospective analysis of the data, our results indicate that laser therapy is efficacious in the conservative treatment of CIN2 p16 positive lesions in carefully selected women. The persistence of the infection from high-risk HPV at follow-up is a significative predictive factor of residual or recurrent CIN after surgery [ 24 , 25 ]. Vaccination with the nonovalent HPV vaccine [ 26 ] among the patients aged between 20- and 45-years old undergoing treatment for CIN2 is a valid addition in the prevention of recurrence.…”

Section: Discussionmentioning

confidence: 99%

Conservative management of CIN2 p16 positive lesions in women with multiple HPV infection

et al. 2020

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Background According to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatment. However, excisional treatment is associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, addressing the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment. Method We studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, biopsy and HPV test and were tested for p16 protein,. Patients were divided based on HPV infection into: single infections, multiple infections. All patients underwent ZTA laser therapy with follow-up (2-year follow-up). Statistical analysis Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p < 0.05 were considered statistically significant. Results Single infections had a histological regression of 61.8% (21/34) and a histological persistence rate of 35.3% (12/34), which was greater than the multiple infection rate. The common characteristic that the women with persistence and progression had was the dimension of the lesion and the genotype 16. Ten cases of histological persistence and the only case of progression had one lesion greater than three quarters of the cervix. Conclusions With the progress of our understanding of the natural history of infection from human papillomavirus and the increasing use of colposcopy, thanks to the addition of HPV genotyping and the technique of immunohistochemistry, conservative management of these lesions is now possible.

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“…We studied the medical records of 130 patients who, from April 2015 to April 2017, had undergone laser therapy for CIN2 at the outpatients' clinic of Colposcopy of the Gynecology Unit of the University Hospital of Catania (University of Catania, Italy) and we selected the women who met the following inclusion criteria: a. Women between the ages of 25 Only 64 patients met the inclusion criteria, from whom we obtained the following clinical data: patient's age, type of pathology, HPV sample, lesion dimensions, method of treatment, data of follow-ups, pretreatment viral genotype, post-treatment HPV genotype and cases of relapse. Each patient underwent colposcopy, speci c biopsy and an HPV test.…”

Section: Methodsmentioning

confidence: 99%

“…Notwithstanding the limits of the retrospective analysis of the data, our results indicate that laser therapy is e cacious in the conservative treatment of CIN2 p16 positive lesions in carefully selected women. The persistence of the infection from high-risk HPV at follow-up is a signi cative predictive factor of residual or recurrent CIN after surgery [24,25]. Vaccination with the nonovalent HPV vaccine [26] among the patients aged between 20-and 45-years old undergoing treatment for CIN2 is a valid addition in the prevention of recurrence.…”

Section: Leep (Loop Electrosurgical Excisionmentioning

confidence: 99%

Conservative management of CIN2p16 positive lesions in women with multiple HPV infection

Bruno

Scalia

Cassaro

et al. 2020

Preprint

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Abstract BackgroundAccording to the 2006 American Society for Colposcopy and Cervical Pathology guidelines, positive CIN2 p16 in women over the age of 25 should be managed with excisional treatment. However, excisional treatment is associated with physical, psychological and obstetric morbidity and can have a negative impact on sexual function. In our study we sought to identify a clear management strategy, addressing the impact of routine use of p16 immunohistochemistry in this population and identify appropriate criteria for patient selection with the aim of reducing over-treatment.MethodWe studied the medical records of 130 patients who had undergone laser therapy for CIN2. Each patient underwent colposcopy, biopsy and HPV test and were tested for p16 protein,. Patients were divided based on HPV infection into: single infections, multiple infections. All patients underwent ZTA laser therapy with follow-up (2-year follow-up ). Statistical analysis Contingency tables were created to evaluate the correlation between single, multiple and CIN2+ infections. Values with p <0.05 were considered statistically significant.ResultsSingle infections had a histological regression of 61.8% (21/34) and a histological persistence rate of 35.3% (12/34), which was greater than the multiple infection rate. The common characteristic that the women with persistence and progression had was the dimension of the lesion and the genotype 16. Ten cases of histological persistence and the only case of progression had one lesion greater than three quarters of the cervix.ConclusionsWith the progress of our understanding of the natural history of infection from human papillomavirus and the increasing use of colposcopy, thanks to the addition of HPV genotyping and the technique of immunohistochemistry, conservative management of these lesions is now possible.

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HPV genotype determination and E6/E7 mRNA detection for management of HPV positive women

Cited by 33 publications

References 29 publications

Multiple HPV infection as possible marker of neoplastic progression

Multiple HPV infection as possible marker of neoplastic progression

Conservative management of CIN2 p16 positive lesions in women with multiple HPV infection

Conservative management of CIN2p16 positive lesions in women with multiple HPV infection

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