Human Papillomavirus Genotyping in Histological Sections of Precursor Lesions of Cervical Carcinoma: Its Role as a Possible Adjunct for the Evaluation of the Oncogenic Potential of Specific Human Papillomavirus Genotypes – A Study in a Coastal Region of Southeastern Spain

Abstract

Background: Human papillomavirus (HPV) genotyping is usually performed on cytological specimens with the aim of discerning between high- and low-risk genotypes. Methods: Paraffin-embedded sections (n = 241) comprising 16 normal/benign (N/B) cervical sections, 72 low-grade squamous intraepithelial lesions (LSIL), 133 high-grade SIL (HSIL), 6 invasive carcinomas (cervical cancer), and 14 atypical immature metaplasias (AIMs) were DNA extracted and HPV genotyped. Results: The most frequent HPV genotypes found were 16 and 58. HPV16 was detected in 0% N/B, 18.1% LSIL, 42.9% HSIL (p < 0.001), 50% carcinoma, and 35.7% AIM, whilst HPV58 was detected in 25.0, 20.8, 16.5, 0 and 35.7% of these lesions, respectively. Discussion: The high prevalence of HPV58 and the low prevalence of HPV18 suggest the limited effectiveness of HPV vaccination in southeast Spain (prevention of 45.1% HSILs). The HPV genotype distribution profile in AIM suggests that these lesions are more similar to LSIL than HSIL pointing to a low risk of progression to cervical cancer. These results reinforce the necessity of assessing the specific genotype rather than distinguishing between high- or low-risk HPV. The use of histological section instead of cytological specimens for specific HPV genotyping would be very useful in order to ascertain the oncogenic potential of each of the genotypes found in a given area.

Genotype distribution of human papillomavirus (HPV) in histological sections of cervical intraepithelial neoplasia and invasive cervical carcinoma in Madrid, Spain

“…HPV 33 presence was basically no difference in CIN1 cases (8.6%) than in CIN2-3 cases (8.9%). This finding is in disagreement with the previously mentioned study carried in a south-eastern region of Spain in which HPV 33 frequency increased in parallel with the severity of the lesion [22]. …”

“…This finding is in accordance with the study carried in a south-eastern Spanish region mentioned above [22]; but it is at variance with the other previously mentioned study carried in a region in eastern Spain, in which the percentages of multiple infections were lower than in our study, and there were no considerable differences between groups of lesions (4.8% in LSIL and 3.7% in HSIL) [19]. …”

“…Our HPV 58 findings are in accordance with other recent study carried in a south-eastern region of Spain in which HPV 58 was the third most common genotype found and its frequency progressively decreased as lesions showed higher grades of dysplasia [22]. As some authors have reported, this decreasing HPV 58 frequency with the severity of the lesion may indicate that, despite the high frequency of HPV58 found in our area, LSIL caused by HPV58 would have less likelihood to progress to HSIL than a LSIL caused by HPV16 [22].…”

“…As some authors have reported, this decreasing HPV 58 frequency with the severity of the lesion may indicate that, despite the high frequency of HPV58 found in our area, LSIL caused by HPV58 would have less likelihood to progress to HSIL than a LSIL caused by HPV16 [22]. …”

Epidemiologic characterization of human papillomavirus (HPV) infection in various regions of Yunnan Province of China

“…Further, infections with a single HR-HPV genotype resulted in an increase in cervical lesion progression. This finding might indicate that there is a lower risk of developing malignancy with multiple genotype infections compared with single genotype infections [ 32 , 33 ] (Table 1 ).…”