Učestalost infekcije HPV-om visokog rizika u premalignim lezijama vrata maternice

master's thesis

• Title (english): Frequency of high-risk HPV infection in premalignant lesions of the uterine cervix
• Author: Dorjana Mačukat
• Mentor: Marija Grdić Rajković (mentor)
• Committee member: Marija Grdić Rajković (predsjednik povjerenstva)
• Committee member: Dubravka Vitali Čepo (član povjerenstva)
• Committee member: Dražan Butorac (član povjerenstva)
• Granter: University of Zagreb; Faculty of Pharmacy and Biochemistry; (Department of medical biochemistry and haematology); Zagreb
• Defense date and country: 2019-05-23, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Pharmacy; Medical Biochemistry

Abstract

HPV je relativno mali DNA virus bez ovojnice, koji taksonomski pripada obitelji Papillomaviridae (rod Papillomavirus). S obzirom na onkogeni potencijal, dijeli se na niskorizične tipove koji uzrokuju benigne bradavice te visokorizične tipove. Visokorizični HPV 16 i HPV 18 odgovorni su za više od 70% karcinoma vrata maternice. Infekcija HPV-om je glavni čimbenik rizika nastanka CIN-a, odnosno premalignih lezija vrata maternice. Promjene koje prethode karcinomu se razvijaju godinama, a da bi se osiguralo uspješno liječenje potrebno ih je otkriti na vrijeme. Cilj rada bio je utvrditi učestalost infekcije visokorizičnim HPV-om u skupinama ispitanica bez premalignih lezija vrata maternice i sa skvamoznom intraepitelnom lezijom niskog (LSIL) i visokog stupnja (HSIL). Nadalje, određivao se postotak ispitanica koje imaju infekciju HPV-om 16, 18 te istovremenu infekciju HPV-om 16 i 18. Istraživanje je uključivalo 169 ispitanica s pozitivnim Papa testom, koje su na temelju patohistološkog nalaza svrstane u skupine bez premalignih promjena vrata maternice i skupine LSIL te HSIL. Za detekciju DNA HPV-a korištena je PCR metoda, odnosno cobas® HPV test (Roche). Udio ispitanica s pozitivnim visokorizičnim HPV-om u skupinama bez premalignih lezija vrata maternice, s LSIL i HSIL lezijama iznosio je 75%, 75% i 99%. U podskupini ispitanica bez dokazanih premalignih lezija vrata maternice, 54,5% ispitanica koje su imale potvrđenu infekciju visokorizičnim HPV-om, imalo je infekciju HPV-om 16, 3% HPV-om 18, a 15% istovremenu infekciju HPV-om 16 i 18. U skupini ispitanica s LSIL lezijama, infekcija HPV-om 16 i 18 dokazana je u 25% i u 4,2% slučajeva, dok je u skupini ispitanica s HSIL lezijama taj postotak iznosio 42,4% i 4,4%. Istovremena infekcija HPV-om 16 i 18 prisutna je u manjem postotku u ispitanica s HSIL lezijom (4,4%) u odnosu na ispitanice s LSIL lezijom (8,3%). Na temelju prikazanih podataka potvrđena je vrlo visoka učestalost infekcije visokorizičnim HPV-om u skupini ispitanica s potvrđenim premalignim lezijama vrata maternice. Očekivano, najveći postotak infekcije visokorizičnim HPV-om nađen je u ispitanica s HSIL lezijama. Međutim, začuđujuće visoki postotak žena bez dokazanih premalignih lezija ima dokazanu infekciju HPV-om visokog rizika i veliku vjerojatnost za razvoj premalignih lezija kroz budući vremenski period. Na temelju prikazanih podataka potvrđena je vrlo visoka učestalost infekcije visokorizičnim HPV-om u skupini ispitanica s potvrđenim premalignim lezijama vrata maternice. Očekivano, najveći postotak infekcije visokorizičnim HPV-om nađen je u ispitanica s HSIL lezijama. Međutim, začuđujuće visoki postotak žena bez dokazanih premalignih lezija ima dokazanu infekciju HPV-om visokog rizika i veliku vjerojatnost za razvoj premalignih lezija kroz budući vremenski period.

Abstract (english)

HPV is a relatively small, non-enveloped DNA virus, which belongs to the Papillomaviridae family (genus Papillomavirus). HPV has been classified into low-risk types and high-risk types, based on its oncological potential. Low-risk types cause benign genital warts. High-risk HPV types, HPV 16 and HPV 18, cause more than 70% of cervical cancer. HPV infection is the main risk factor for CIN or cervical premalignant lesions. It takes years for premalignant lesions to occur, so it is important to discover them on time to provide successful treatment. The aim of this study was to determine the frequency of high-risk HPV infection in groups of patients without premalignant lesions, with low-grade squamous intraepithelial lesion (LSIL) and high-grade squamous intraepithelial lesion (HSIL). Furthermore, the aim was to investigate the percentage of women who had HPV 16, HPV 18 and infection with HPV 16 and HPV 18 at the same time. 169 women were enrolled in the study and had positive Pap test results. All of them were classified based on pathohistological analysis into groups of subjects without premalignant lesions of the uterine cervix and groups of subjects with LSIL and HSIL. PCR method that has been used for HPV DNA detection in cervical DNA samples is cobas® HPV test (Roche). Percentage of women who were high-risk HPV positive in the groups of women without premalignant lesions of the uterine cervix, with LSIL and HSIL was 75%, 75% and 99%. In the group of women without premalignant cervical lesions, 54,5% women with confirmed high-risk HPV infection had an infection with HPV type 16, 3% had an infection with HPV type 18, and 15% had multiple infections with both HPV 16 and HPV 18. In the group of women with LSIL, infection with HPV type 16 and HPV type 18 has been proven in 25% and 4,2% of women, whereas in the group of women with HSIL frequency of HPV 16 and HPV 18 was 42,4% and 4,4%. Multiple infections with both HPV type 16 and HPV type 18 were found less frequent in women who had HSIL (4,4%) compared to women who had LSIL (8,3%). Based on the results shown in the study, a very high frequency of high-risk HPV infection was confirmed in the group of women with confirmed premalignant cervical lesions. Expectedly, the highest percentage of high-risk HPV infection was found in the group of women with HSIL lesions. However, surprisingly high percentage of women without proven premalignant lesions have been proven high-risk HPV infection and have a high probability of developing premalignant lesions in the future.

• Keywords: HPV; infekcija HPV-om; visokorizični HPV; LSIL; HSIL; cervikalna intraepitelna neoplazija; premaligne promjene vrata maternice; cobas
• Keywords (english): HPV; HPV infection; high-risk HPV; LSIL; HSIL; cervical intraepithelial lesion; premalignant lesions; cobas
• Language: croatian
• URN:NBN: urn:nbn:hr:163:865451
• Study programme: Title: Medical biochemistry; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: magistar/magistra medicinske biokemije (magistar/magistra medicinske biokemije)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2019-09-06 14:14:53