Human papillomavirus types 16, 18 DNA, chalmydia antigen and tumour necrosis factor alpha in cervical cancer in women from Dakahlia, Egypt

ABSTRACT

Infection with human papillomavirus [HPV] and Chlamydia trachomatis are associated with cervical intraepithelial neoplasia. The recognition of HPV infection as a factor that is necessary, but not sufficient, for the development of cervical cancer has resulted in the initiation of several longitudinal studies and randomized clinical trials designed to examine the predictive value of HPV DNA testing. Forty two women were enrolled in this study [patients group] together with 20 apparently normal women [control]. For all patients and control groups, cervical swabs were taken, examined for HPV, HPV 16, HPV 18 DNA by 2 sequential PCR reactions, Chlamydia antigen and TNF-alpha by ELISA. Among 42 cases diagnosed pathologically as cervical carcinoma, HPV DNA was detected in 37 cases [88.09%]. HPV16 DNA was more common than HPV18 DNA as it was detected in 28 cases [66.7%] while HPV18 DNA was detected in 4 cases [9.5%]. There is a statistically significant difference between HPV and control cases, also HPV16 and control cases. Regarding Chlamydia antigen, 10 cases were detected out of 42 cases [23.8%] while, only 3 cases were detected in control group [15%] indicating that there is non statistically significant difference between the two groups. Regarding the pathological types of cervical carcinoma, in adenocarcinoma, HPV DNA was detected in 4 cases [80%], while in Squamous cell carcinoma [SCC], it was detected in 33 cases [89.19%]. In adenocarcinoma, HPV 16 DNA was detected in 2 cases [40%], while in SCC, it was detected in 26 cases [70.27%]. In adenocarcinoma, HPV 18 DNA was detected in 1 case [20%], while in SCC, it was detected in 3 cases [8.11%]. Regarding Chlamydia antigen, in adenocarcinoma, the antigen was detected in 1 case [20%] and in SCC, it was detected in 9 cases [24.32%]. Our results emphasized that HPV 16 was more predominant in squamous cell carcinoma, whereas type 18 was relatively high in adenocarcinoma. The level of TNF-alpha [pg/ml] was 33.81 +/-9.38 in cancer cervix cases, which was statistically significant compared to control cases [1.33 +/-0.74 [P<0.001]]. There is none statistically significant difference between adenocarcinoma [34.12 +/-12.31] and SCC [33.76 +/-9.13 [P=0.970]]. There was no significant difference regarding TNF-alpha level between HPV positive cases [34.23 +/-9.39] and HPV negative [30.66 +/-9.68 [P = 0.342]]. There was a significant difference between HPV16 [32.88 +/-8.84] and HPV18 [41.98 +/-4.32]. Also, there was no significant difference between Chlamydiae positive cases [36.62 +/-8.79] and Chlamydiae negative cases [32.93 +/-9.52 [P=0.260]]. We conclude that cervical infection with HPV but not with Chlamydia may be an important risk factor for the development of cervical cancer and TNF-alpha levels increased significantly in cervical carcinoma without special reference to the pathological type of the tumor