Conformity of Human Papillomavirus between Self-examination of Vaginal Fluid and Cervical Specimen with Fluid-Based Cytology in Precancerous Lesions

Objective: To determine the conformity of human papillomavirus between self-examination of vaginal specimen and cervical specimen with fluid-based cytology in precancerous lesions. Methods: A cross-sectional study performed on cervical and vaginal fluid from 90 pre-cancerous lesions patients from April to September 2016. Cytological examination performed with self-examination and liquid-based cytology technique. HPV genotyping performed with PCR technique. Data were analyzed with SPSS. Results: Most of the women aged >35 years (89%), 78% (71/90) multiparity and 74.4% (67/90) do not know about HPV screening. High risk type found in both vaginal and cervical fluid was type 16, 18, 33 and 45 whereas type 35 found only in vaginal fluid. The most prevalent high-risk HPV for both specimens were type 16 and 18. HPV type 42 and 53 were the low risk HPV found in the vaginal and cervical specimens (table 2). Cohen’s kappa for inter-test agreement shows a strong correlation (r=0.864). Conclusion: The HPV self-examination method can be used as a primary examination of cervical cancer lesions detection in addition to fluid-based cytology with the similar results. Keywords: Human papillomavirus, self-examination, fluid-based cytology, cervical cancer Abstrak Tujuan: Untuk mengetahui tingkat kesesuaian antara pemeriksaan HPV mandiri dari spesimen vagina dan hasil pemeriksaan sitologi berbasis cairan dari spesimen serviks. Metode: Penelitian cross-sectional dilakukan pada cairan serviks dan vagina dari 90 pasien lesi pra-kanker pada April sampai September 2016. Pemeriksaan sitologi dilakukan dengan pemeriksaan diri dan teknik sitologi berbasis cairan. Pemeriksaan genotip HPV dilakukan dengan teknik PCR. Data dianalisis dengan SPSS. Hasil: Sebagian besar wanita dalam penelitian iniaberusia >35 tahun (89%), 78% (71/90) multiparitas dan 74,4% (67/90) tidak mengetahui tentang skrining HPV. Tipe HPV risiko tinggi yang ditemukan pada cairan vagina dan serviks adalah tipe 16, 18, 33 dan 45 sedangkan tipe 35 hanya ditemukan pada cairan vagina. Tipe HPV risiko tinggi yang dominan untuk kedua spesimen adalah tipe 16 dan 18. HPV tipe 42 dan 53 adalah HPV risiko rendah yang ditemukan pada baik spesimen vagina maupun serviks. Kappa Cohen untuk tingkat kesesuaian antara pemeriksaan mandiri dan sitologi berbasis cairan menunjukkan korelasi kuat (r = 0,864). Kesimpulan: Metode pemeriksaan HPV secara mandiri sendiri dapat digunakan sebagai pemeriksaan primer deteksi lesi kanker serviks selain sitologi berbasis cairan dengan hasil yang sama.

VEGF +936 C/T Genetic Polymorphism in Patients with Cervical Dysplasia

Aim. The present study aims to analyze the potential role of VEGF +936 C/T polymorphism in cervical intraepithelial neoplasia.Material and Method. One hundred and eighty-six patients were included in the study: 75 cases (patients diagnosed with CIN) and 111 controls (negative for both HPV testing and cytology). For each patient a single visit was scheduled when colposcopy was performed. From cervical specimen, cytology and HPV testing were performed and from peripheral blood VEGF +936 genotyping was determined. For statistical analysis purposes OR and chi-square were used at a level of significance of <0.05.Results. No link has been found in the detection of CT genotype in cases versus controls, OR = 0.8295, [0.42, 1.62]. An inverse correlation has been found between T allele and HSIL, OR = 0.2121, [0.0473, 0.9517],p=0.0866.Conclusion. No link has been found between VEGF +936 C/T and cervical intraepithelial neoplasia.

Increased expression of galectin-1 during the progression of cervical neoplasia

Galectin-1, a member of the β-galactoside-binding family, is widely expressed in epithelial and immune cells. It is involved in several normal and pathologic processes, such as cancer progression, metastasis, and immunobiology. Galectin-1 was found to be overexpressed in various cancer cells and the corresponding benign tissue. Therefore, it has been described as a marker for tumor progression in some malignancies. In the current study, the expression of galectin-1 was examined in 80 formalin-fixed, paraffin-embedded cervical tissues: 20 benign cervical specimen, 20 low-grade squamous intraepithelial lesions (LGSIL), 20 high-grade squamous intraepithelial lesions (HGSIL), and 20 invasive squamous cell carcinomas (ISCC). Immunohistochemical analyses showed that the intensity of the galectin-1 expression on stromal cells next to the transformed cells increased according to the pathologic grade: benign cervical tissue < LGSIL < HGSIL < ISCC (P < 0.001). The epithelial cells were always negative for galectin-1. These results suggest that galectin-1 expression on stromal cells increases with the histopathologic grade of cervical tissues, and it can be concluded that this increase is associated with the progression of cervical neoplasia.

Comparison of PCR- and Hybrid Capture-Based Human Papillomavirus Detection Systems Using Multiple Cervical Specimen Collection Strategies

This study compared the performances of three human papillomavirus (HPV) detection tests with specimens collected by three alternative procedures. The HPV tests included the Hybrid Capture Tube test (HCT), the microplate-based Hybrid Capture II test (HC II), and the MY09-MY11 L1 consensus primer PCR-based assay. Initial cervical specimens were collected from study subjects with a broom device, and after Papanicolaou smears were made, residual specimens were placed into PreservCyt (PC), a liquid cytology medium. A second specimen was collected from each subject and placed into Digene Specimen Transport Medium (STM). The device for collection of the second specimen alternated with consecutive subjects between a conical cytology brush and a Dacron swab. At the 1.0-pg/ml cutoff, the results of the HC II agreed well with those of the PCR. Specifically, when PCR data were restricted to the types found by the HC II (HPV types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68), there was greater than 90% agreement between the HC II and PCR results with both STM and PC. At a lower cutoff (0.2 pg/ml), HC II-positive results increased further, especially when the test was applied to the PC specimens. However, false-positive HC II results were more often observed at the 0.2-pg/ml cutoff. HC II yielded the highest HPV positivity with specimens placed into PC, followed by specimens collected with a conical brush and placed into STM and, last, by those collected with a Dacron swab and placed into STM. Our results demonstrate the utility of both the STM and PC specimen collection methods and show good agreement between the HC II and PCR.