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01.10.2013 | original article | Ausgabe 19-20/2013

Wiener klinische Wochenschrift 19-20/2013

Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 19-20/2013
Autoren:
Lucia Rössler, Assoc. Prof. Olaf Reich, Assoc. Prof. Reinhard Horvat, Sabrina Collas de Souza, PhD Katsyarina Holl, MD Elmar A. Joura

Summary

Background

The purpose is to present the Austrian data of an observational, cross-sectional, multicentre study conducted in 13 European countries. This study was undertaken to assess human papillomavirus (HPV) type distribution in high-grade cervical lesions.

Methods

Two hundred and ninety cases of high-grade cervical intraepithelial neoplasia (CIN2, CIN3) or adenocarcinoma in situ of the cervix from 2004 to 2007 were analysed by histopathological review and polymerase chain reaction for HPV.

Results

Two hundred and nine cases were “histologically eligible” and of those 206 were HPV+. Median age was 34 years (19–76 years). CIN3 was the most frequent diagnosis (64.6 %), followed by CIN2/3 (19.4 %) and CIN2 (13.6 %). Adenocarcinoma in situ was only detected together with a squamous lesion in 2.4 % cases. Majority of women (75.2 %) were infected with a single HPV type, 98.1 % of them with high-risk HPV types: HPV 16 (56.1 %), HPV 33 (12.3 %), HPV 31 (11.0 %), HPV 18 (3.9 %), HPV 35 (3.9 %), HPV 51 (3.2 %) and HPV 52 (2.6 %), HPV 58 (1.9 %) and HPV 45 (0.6 %). The low-risk HPV 6 was found in 1.3 % cases. Forty-six lesions (22.3 %) contained multiple infections, 71.1 % of those were HPV 16 or 18 and 91.1 % were HPV 16, 18, 31, 33 or 45 positive.

Conclusions

These Austrian data clearly demonstrate that HPV 16 is the predominant type in high-grade CIN, the immediate precursor lesions of cervical cancer. More than 60 % of the lesions were associated with HPV 16 and 18 and more than 85 % with HPV 16, 18, 31, 33 or 45. The prevalence of adenocarcinoma in situ is underestimated, since its detection is difficult with the current cytology screening.

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