HPV Genotyping in Korean Women with Cervical Neoplasia

Park, Tae Chul; Kim, Chan Joo; Lee, Keun Ho; Yoon, Joo Hee; Kim, Ji Hoon; Koh, Young Me; Namkoong, Sung Eun; Park, Jong Sup

Abstract

OBJECTIVE
It has been widely acknowledged that human papillomavirus (HPV) is the most important cause of cervical carcinoma, and the HPV DNA test has been proved as an effective adjuvant to Pap smear. As the development of HPV vaccine is now at the planning stage, the role of HPV genotype profile has become very important in early diagnosis, management and prevention of cervical neoplasia.
METHODS
Analysis was made on the HPV genotype profile of a number of the inpatients and outpatients who visited at the Department of Gynecology, Kangnam St. Mary's Hospital between November, 2001 and May, 2002, based on the Pap smear test and tissue pathology. The age range of the patients covered in this study was between 21 years and 91 years and the average age of the patients was 43.4 years. Based on the results of the Pap smear and tissue pathology, the patients were broken down into the following 4 groups; the women with normal cytology (n=290), the patients with LSIL (low-grade squamous intraepithelial lesion); koilocytosis and mild dysplasia (n= 68), the patients with HSIL (high- grade squamous intraepithelial lesion); moderate and severe dysplasia, or carcinoma in situ (n= 51), and the patients with cervical cancer (n=55), respectively and a study was made on the HPV genotype profile of cervix of each of the above 4 groups by utilizing HPV DNA chip.
RESULTS
The proportions of the detected HPV-16 in the individual groups were 7.9% (23/290) for women with normal cytology, 24.2% (16/68) for the patients with LSIL, 33.3% (17/51) for HSIL, 75.8% (47/62) for those with cervical cancer, respectively and it was noticed that detection rates increased significantly in accordance with advancing the severity of cervical lesions (P<0.01). Of the rest of the HPV types, HPV -18, -33, -35, -39, -52, -56, -58 were related with cervical cancer (P<0.05); HPV-18, -58 were related with HSIL (P<0.05); HPV -18, -39, -51, -52, -58, -68 were related LSIL (P<0.05). In the case of multiple HPV infections, 19 (37.3%) were detected in women with normal cytology, 21 (42.0%) were detected in patients with LSIL, 13 (27.7%) were detected in HSIL, and 17 (28.8%) were detected in those with cervical cancer, respectively, but there was no statistically significant differences.
CONCLUSION
As a result of this study, HPV genotype profiles and multiple infections by pathological severity can be obtained for the Korean female patients groups ranging from normal cervical cytology through cervical intraepithelial neoplasia to cervical carcinoma. It is expected that the results of this study might be utilized as a molecular biological index to determine prognosis of HPV infection and cervical dysplasia or as an adjunctive diagnostic method for early detection of carcinoma in situ and cervical carcinoma, and that the results can also become very valuable basic data that can be used in developing HPV vaccine for prevention of cervical carcinoma in the near future.