[Prevalence of high risk oncogen HPV by in situ hybridization and by PCR in condyloma acuminata in the region of the Tunisian center]

The aim of this study was to evaluate the frequency of "high-risk" HPV types in condyloma acuminata in patients from Tunisian Center. Thirty two paraffin-embedded biopsies were analyzed for the presence and type of HPV DNA by means of in situ hybridization [ISH] and polymerase chain reaction [PCR] techniques. ISH was done using a broad spectrum HPV biotinylated DNA probe for the detection of HPV DNA. HPV typing was carried out using specific probes for HPV types 6/11, 16/18 and 31/33. HPV DNA was amplified by PCR using the degenerate primers E1350L/E1547. HPV were typed by pU-1M/PU-2R primers for the oncogenic HPV types 16, 18, 31 and 33, and PU-31B/PU-2R for "low-risk" group [6 and 11]. Using ISH, HPV was detected in 27 out 32 cases [84.4%]. All were HPV 6/11 positive. Co-infection with oncogenic HPV was found in one case that reacted with 16/18 and 31/33 probes. Good quality DNA was obtained in 13 cases. HPV was detected by PCR in 11 of 13 specimens [80.6%] when E1350L/E1547 primers were used. HPV 6/11 were present in all cases. The results of this study provide specific confirmation of the predominance of HPV6/11 and low rate of co-infection in patient from Tunisian Center. Because of the difficulty of DNA extraction, risk of DNA degradation and contamination associated with PCR, the ISH remains more adapted to archival materiel especially in routine clinical practice

HPV typing and cervical cancer screening: results of Moroccan critical study

Cancer of the uterine cervix, the second most frequent cancer after breast cancer in Morocco, is closely linked to several types of Human Papilloma Virus [HPV] especially the potentially oncogenic types 16 and 18 mostly found in high grade precancerous lesions and uterine cervix cancer. In the Bethesda cytological classification, HPV infection and Cervical Intraepithelial Neoplasia grade I [CIN 1] are classified as Low grade Squamous Intraepithelial Lesions [LSIL] whereas CIN 2 and CIN 3 are considered High grade Squamous Intraepithelial Lesions [HSIL]. The cytologic diagnosis of HPV infection on cervical Pap smears relies on the association of several criteria of which koilocytosis is considered specific of HPV infection. Colposcopy and direct biopsies are therefore necessary to cofirm the diagnosis. Nevertheless, since the introduction of HPV typing in uterine cervix cancer screening, koilocytosis is disregarded as a necessary criteria for the diagnosis of HPV infection. The authors report the results of a study which corroborate this statement and correlate histopathology and HPV typing of benign lesions collected at our institution [INO]. Guidelines for follow-up are also discussed according to the data in the literature

Human papillomavirus deoxyribonucleie acid testing in screening of high grade cervical intraepithelial neoplasia

To test the role of human papillomavirus DNA Hybride Capture II in the screening of cervical intraepithelial neoplasia in a large group of 1,158 women refered with abnormal cytology and colposcopy or both from 102 outpatient clinics in the Czech Republic. The study group consists of 1,158 women. Their cervical scrabs were sent to the KLINLAB/Clinical Laboratories Prague during a period of two years 1997-1998, because of the abnormal results obtained in the primary screening. Patients diagnosed with abnormal colposcopy and cytology, ASCUS, AGNUS, LSIL, HSTL were eligible for this study. Only fully completed records of women human papillomavirus test, cytology, colposcopy, biopsy were accepted for assessment. The median age among the 1,158 women was 34.7 years range 16-73, 245/21% of the patients had high grade cervical intraepithelial neoplasia or microinvasive cancer. Human papillomavirus testing detected 171 cases 70% of high grade disease. The sensitivity of cytology of women with minor cytological abnormality, ASCUS, LSIL, for major cervical disease of cervical intraepithelial neoplasia 2/3 or microinvasive cancer was only 35%. The overall sensitivity of human papillomavirus DNA testing was 66%. A combined cytology and human papillomavirus DNA test gave an increased sensitivity for major cervical disease of 83%. Our results suggests that cytology alone is not sufficient in common clinical practice for the screening of neoplastic non invasion lesions of the cervix. One hundred and fifty three, 66.5% of the cervical intraepithelial neoplasia 2/3 and 8 cases of microinvasive cancer showed negative, borderline or mild cytological changes. The combined use of cytology with human papillomavirus testing increased the sensitivity with a reduction in specificity. We suggest the human papillomavirus testing could helpfully amplifying but not replace cytology in screening of cervical intraepithelial neoplasia