Correlation between cytological findings in patients with diagnosis of ASCUS, LSIL and HSIL with HPV subtyping

Abstract

Background and objective: Uterine Cervical Neoplasm is caused by untreated and undiagnosed precancerous lesions that are not diagnosed in time. Cervical precancerous lesions are divided into four categories: [CIN] grades 1, 2, and 3, and carcinoma in situ or adenocarcinoma in situ. According to the Bethesda system, CIN1 is considered as LSIL, and CIN2, CIN3, and carcinoma in situ are considered HISL. Cervical SCC and adenocarcinoma progress through stepwise precancerous phases after persistent infection with high-risk HPV types.HPV subtypes are divided into two groups: high risk and low risk. Early detection of cervical cancer and dysplasia is important, not only with regard to the patient’s life but for preservation of fertility. Recently, the results of a number of randomized controlled trials showing the effectiveness of screening using cytology and HPV testing have been reported. However, studies on the prevalence of human papillomavirus subtypes in various lesions have not been studied. Therefore, the aim of the present study was to determine the common types of human papillomavirus subtypes in each of the ASCUS, LSIL, and HSIL lesions. Materials and Methods: In this study, a cross-sectional study of all patients referred to Dr. Dastranj Pathology Laboratory in Tabriz who underwent Pap smear screening and their Pap smear test was in accordance with the terminology of Bethesda reporting system with epithelial cell abnormality, was reviewed. Abnormal cases were divided into three groups based on Bethesda system terminology: ASCUS, LSIL, HSIL. Then, the results of HPV subtyping of all the above patients were evaluated. Study information was extracted from patients' clinical records. The statistical relationship between the findings was studied. The data obtained from the study were analyzed using statistical software spss.16. Results: In the abnormal examples of each lesion, the frequency of Low risk and High risk types is as follows: In ASCUS lesions, Low risk types were observed in 42.86% of the samples and High risk types were observed in 76.19% of the samples. The highest frequency was related to type 16 subtype with 42.86% frequency and then type 11 subtype with 23.81% frequency. In LSIL lesions, Low risk types were observed in 42.86% of samples and High risk types were observed in 83.33% of samples. The highest frequency was related to type 13 subtype with 30.95% frequency and then type 10 subtype with 23.81% frequency. In HSIL lesions, Low risk types were observed in 100% of the samples and High risk types were observed in 50% of the samples. There were three types of subtypes 16, 6 and 87 with similar frequency.