Human papillomavirus types in glandular lesions of the cervix: A meta‐analysis of published studies

Abstract

Dear Editor, Glandular preinvasive lesions of the cervix (i.e., atypical glandular cells, AGC and adenocarcinoma in situ, AIS) are more likely to be missed in cytological cervical screening than their squamous-cell equivalents, owing to their location in the endocervical canal and difficulties in their cytological and colposcopical assessment. 1,2 Hence, in well-screened populations, although the incidence of cervical cancer has been decreasing over the last three decades, the ratio of adeno/adenosquamous (ADC) to squamous cell carcinoma (SCC) has been rising. 1,3 Screening using high-risk (HR) HPV rather than cytology can improve prevention of ADC. 4 Human papillomavirus (HPV) 18 is more frequently detected in ADC than in SCC and this tendency may also apply to other types (e.g., HPV45) that belong to the same alpha-7 species as HPV18. 5 However, in contrast to the extensive information about HPV types across the complete spectrum of squamous cervical lesions, 6 little is known about the pattern of HPV types in glandular preinvasive lesions, and how it compares to that in ADC.With the aim to improve our understanding of the carcinogenic process for individual HR types from infection of glandular tissue to adenocarcinoma, we performed a systematic literature review of HPV type-specific prevalence data in preinvasive glandular neoplastic lesions, and compared to similar data on women with normal cytology and ADC reported in a recently published meta-analysis. 6 Methods have been reported previously. 6 In brief, Medline was used to search for publications from January 1990 to November 2011 using combinations of the MeSH terms: ''cervical cancer,'' ''cervical intraepithelial neoplasia,'' ''HPV,'' ''human,'' ''female'' and ''polymerase chain reaction.'' Eligible studies met the following criteria: (i) use of broad-spectrum consensus PCR-assays based on the primers MY09/11, PGMY09/11, GP5þ/6þ, SPF10, SPF1/GP6 or L1C1/L1C2, and (ii) reporting of overall and type-specific HPV prevalence, by strata of cyto-and/or histo-pathological cervical diagnoses.Overall HPV prevalence is reported as a percentage of all women tested by consensus PCR. Type-specific HPV positivity is presented among HPV-positive women only, for each of the 13 HR HPV types judged to be carcinogenic or probably carcinogenic (i.e., HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68), 1 in the order of their frequency of detection in ADC. 7 Type-specific positivity includes that contributed by single and multiple HPV infections. Standard errors of type-specific positivity estimates were computed assuming the nonindependence of cases within the same study using cluster-correlated robust variance estimates. 8 We identified 12 studies reporting relevant data on AGC and/or AIS from Europe (n ¼ 4, Belgium, Italy and two studies from The Netherlands), North America (n ¼ 5, all from the United States), Eastern Asia (n ¼ 1, Thailand), Western Asia (n ¼ 1, Kuwait) and South/Central America (n ¼ 1, Brazil). As data on both AGC and AIS were available only for...

Viral and Cellular Biomarkers in the Diagnosis of Cervical Intraepithelial Neoplasia and Cancer

“…HPV16 is the most prevalent genotype in both squamous cell carcinoma (59.3%) and adenocarcinoma (36.3%) across the world [8]. HPV18, the second most common genotype, has been found in a higher proportion of adenocarcinoma (36.8%) compared to squamous cell carcinoma (13.2%) [8, 9]. Other oncogenic HPVs have a lower prevalence but still contribute to a significant fraction of cervical cancer [8].…”

Human Papillomavirus 18 Genetic Variation and Cervical Cancer Risk Worldwide

“…HPV18 was first described in 1984 (1) and is the prototype member of the alpha-7 HPV species. Based upon its enrichment in cervical cancer compared to the level in cytologically normal women (2) and its presence in 16% of cervical cancers worldwide (3), HPV18 is widely accepted as the second most carcinogenic HPV type after HPV16.…”

Human Papillomavirus 45 Genetic Variation and Cervical Cancer Risk Worldwide

“…In addition to being a member of the same phylogenetic species (alpha-7) as HPV18 (10,11), HPV45 is similarly more common in adenocarcinoma than in squamous cell carcinoma of the cervix (12,13). Approximately 5% of cervical cancers worldwide are positive for HPV45, although this proportion was reported to vary from 3% in Eastern Asia up to 9% in Africa (14).…”