Cytohistologic changes in women positive for human papillomavirus DNA : a follow up study

Abstract

Objectives To study cytohistologic changes from women with HPV DNA tests positive. Materials and Methods: From July 2007 to Jan 2017, the archival files of CH Pathology, limited (from July 2007 to August 2015) and Pathology@PBH (from August 2015 onward), which includes the files of all cases with HPV positive, were reviewed for follow up study. Total cases which HPV DNA genotyping test were positive were reviewed. Cytologic or histopathologic results were found out to analysis. IBM SPSS statistics (International Business Machines Corporation Statistical Product and Service Solutions) was the tool for data treatment, using Pearson’s X2 test and continuity correction test (Yates corrected X2 test) (For n ≥ 40, 1≤ E <5), Fisher’s exact probability test (For n < 40 or E <1). All p values were two - sided, and p ≤ 0.05 was defined as statistic significant. Results A total of 1335 cases of women with HPV positive, aged 15 to 81 years were analyzed, including 865 (64.8%) cases with high-risk HPV positive only, 290 (21.9%) patients with low-risk HPV positive only, 180 (13.5%) cases with both high-risk and low-risk HPV positive. In descending order, the most common three high-risk HPV genotypes were HPV type 52 (19.7%), HPV type 16 (12.0%) and HPV type 58 (%); the most common three low-risk HPVs were HPV type 54 (12.3%), HPV type 42 (10.1%) and HPV type 6 (%). High-risk HPV positive only were associated with ASC-US (p = 0.000004), LSIL (p = 0.012), HSIL (p = 0.050). Low-risk HPV positive only were associated with ASC-US (p = 0.000001), ASC-H (p = 0.005). ASC-US was associated with HPV type 33 (p = 0.0013), HPV type 40 (p = 0.003) and HPV type 42 (p = 0.0033). LSIL was associated with HPV type 53 (p < 0.00001), HPV type 56 (p< 0.00001), HPV type 59 (p = 0.0035), HPV type 66 (p < 0.00001), HPV type 40 (p = 0.024), HPV type 42 (p = 0.003). HSIL was associated with HPV type 16 (p=0.000013) and HPV type 52 (p=0.013). CIN I was associated with HPV type 59 (p = 0.002). CIN II was associated with HPV type 16 (p = 0.003). Conclusions In descending order, the most common three genotypes of high-risk HPV infection are HPV type 52, 16 and 58; the most common three genotypes of low-risk HPV infection are HPV type 54, 42 and 6. The majority abnormalities of cytologic change after HPV infection are ASC-US and LSIL. High-risk HPV is associated with HSIL. HPV type 59 is associated with CIN I, HPV type 16 is associated with CIN II.