Correlation of High-Risk HPV Genotypes with Pap Test Findings: A Retrospective Study in Eastern Province, Saudi Arabia

Abstract

Introduction: High-risk human papillomavirus (HR HPV) is found to be responsible for 4.5% of cancer in general, primarily cervical cancer. We aim here to highlight the prevalence and genotypes of HR HPV and correlate its association with Pap tests’ results, which are still not well known in the Eastern Province of Saudi Arabia. Methods: Over 7 years (2013–2019), the results of 164 Saudi women coinvestigated for HR HPV along with Pap tests were collected from the archive of King Fahd University Hospital. Only women who had atypical squamous cells of undetermined significance (ASCUS) on the Pap test and those at elevated risk of infection were cotested for HR HPV; otherwise, the Pap test was the only screening modality for cervical cancer. Data were organized and statistically analyzed using IBM SPSS v26. Results: Out of 164 Saudi women, 14.5% (n = 24/164) showed positive results for HR HPV (8 patients had HPV16 and 2 had both HPV16 and HPV18/45, while the remaining 14 had other HR HPV); among them, 41.5% (n = 10/24) had an abnormal Pap test (5 ASCUS and 5 LSIL), while 58.5% (n = 14/24) had a negative Pap test. On the other hand, 21% (n = 35/164) of patients, in the study, had an abnormal Pap test (24 ASCUS, 8 low-grade squamous intraepithelial lesion [LSIL], and 3 atypical glandular cell [AGC]). In 80% (n = 19/24) of ASCUS cases, HR HPV was not detected; however, 20% (n = 5/24) were positive for other HR HPV. Concerning LSIL cases, 62.5% (n = 5/8) were positive for HR HPV (1 case showed HPV16 and HPV18/45, 2 cases showed HPV16, and 2 cases showed other HR HPV), while in the remaining 37.5% (n = 3/8) LSIL cases, HR HPV was negative; similarly, all AGC cases were negative for HR HPV. Statistical analysis showed a significant correlation between HPV status and Pap test findings (p value <0.001). Discussion/Conclusion: HR HPV frequency and genotype distribution, in this study, might reflect a different regional infection pattern. The high association of HR HPV with negative cytology emphasizes the need to add the HR HPV test to screening modalities of cervix cancer.

Assessment of Cervicovaginal Smear and HPV DNA Co-Test for Cervical Cancer Screening: Implications for Diagnosis and Follow-Up Strategies

“…In our study, similar to the study by Kussaibi H. et al [20], a high correlation was found between HPV-DNA test and positive cytology and biopsy. There was a significant correlation between HPV-DNA test and cervicovaginal smear result and cervical biopsy (p = 0.0003, p = 0.0002, respectively).…”

Use of extended HR-HPV Genotyping in improving the Triage Strategy of 2019 ASCCP recommendations in Women with positive HR-HPV diagnosis and Simultaneous LSIL Cytology Results

“…Hence, risk stratification strategies that can better identify underlying or incipient CIN2, CIN3, adenocarcinoma in situ (AIS), or cancer (CIN2+) with less resource waste are needed in HPV-positive patients with LSIL. However, most of the related articles published to date have mainly investigated HPV-positive patients with LSIL using the cytology as a primary screening method but not the HPV testing [17][18][19][20][21]. Moreover, no study has yet addressed application of the 2019 ASCCP guidelines in such patients.…”

Genetic variation of E6, E7, and L1 genes of human papillomavirus 51 from central China

“…Across the world, 95% of cervical cancer are caused by high‐risk human papillomavirus (HR‐HPV) infection 1 . Dozen of HR‐HPV types are highly involved in cervical cancer, and the prevalence and genotypes of HR‐HPV are associated with several factors, such as different locations and ethnicities 2,3 . Persistent HR‐HPV infection can lead to an increased incidence of cervical and intraepithelial neoplasia, and effective inoculation of the HPV vaccine can effectively reduce the risk of invasive cervical cancer 4–6 .…”