RESUMO
BACKGROUND: The human papillomavirus (HPV) Persistence and Progression Cohort is a natural history study of carcinogenic HPV positive women. Here, we present the HPV genotypes found in first â¼500 cases of cervical intraepithelial neoplasia grade 3 (CIN3) or more severe disease (CIN3+) diagnosed at the study baseline. METHODS: Women aged 30 and older were screened for cervical cancer using Pap smears and tested for carcinogenic HPV using Hybrid Capture 2 (HC2; Qiagen). We randomly selected women who tested HPV positive and were diagnosed with CIN3+ (n = 448) or without CIN3+ (Assuntos
Adenocarcinoma/genética
, Carcinoma de Células Escamosas/genética
, DNA Viral/genética
, Papillomaviridae/genética
, Lesões Pré-Cancerosas/genética
, Displasia do Colo do Útero/genética
, Neoplasias do Colo do Útero/genética
, Adenocarcinoma/patologia
, Adenocarcinoma/virologia
, Adulto
, California
, Carcinoma de Células Escamosas/patologia
, Carcinoma de Células Escamosas/virologia
, Estudos de Coortes
, Feminino
, Genótipo
, Humanos
, Teste de Papanicolaou
, Papillomaviridae/classificação
, Infecções por Papillomavirus/genética
, Infecções por Papillomavirus/patologia
, Infecções por Papillomavirus/virologia
, Reação em Cadeia da Polimerase
, Lesões Pré-Cancerosas/patologia
, Lesões Pré-Cancerosas/virologia
, Prognóstico
, Fatores de Risco
, Neoplasias do Colo do Útero/patologia
, Neoplasias do Colo do Útero/virologia
, Esfregaço Vaginal
, Displasia do Colo do Útero/patologia
, Displasia do Colo do Útero/virologia
RESUMO
Cervical cancer is the second most common cancer among Tunisian women, and the incidence rates vary by region. Three Tunisian registries report age-standardized rates of 6.3/10(5) in the central region, 5.4/10(5) in the north, and 2.7/10(5) in the south. High-risk human papillomavirus (HPV) types and their variants differ in carcinogenic potential and geographic distribution. The HPV type and variant distribution could be a factor in the differing rates between regions of Tunisia. Tumor tissue was collected from 142 Tunisian cervical cancer patients. Demographic and reproductive characteristics of the patients were abstracted from cancer registry and hospital records. HPV type and variant analyses were performed using PCR-based Luminex and dot-blot hybridization assays. Eighty-three percent of tumors were infected with at least one HPV type. European variants of HPV16/18 were the most prevalent in tumors from all three regions, with all HPV18 infections and 64% of HPV16 infections being of European lineage. A higher frequency of HPV16 was present in Northern Tunisia (80%) than in Central (68%) or Southern Tunisia (50%) (P=0.02). HPV18/45 was significantly more common in adenocarcinomas (50%) than in squamous cell carcinomas (11%) (P=0.004). Frequent infection with European HPV variants most likely reflects the history of European migration to Tunisia. In addition to the importance of understanding the variants of HPV in Tunisia, behavioral and cultural attitudes towards screening and age-specific infection rates should be investigated to aid the development of future vaccination and HPV screening programs and policies.