Human papilloma virus in cervical intraepithelial neoplasia

The aim: to assess the prevalence and genetic diversity of high-risk human papillomavirus (hrHPV) in intraepithelial lesions of the cervix of varying severity in women (using the Gomel region as an example).

Materials and methods. Cytological examination and testing for HPV were carried out from 2018 to 2021 using the Abbott RealTime hrHPV kit for high-risk HPV on the Abbott m2000sp device. This test separately detects HPV 16, HPV 18 and a pool of 12 additional hrHPV types, further genotyping was carried out using the AmpliSens hR HPV genotype-FL reagent kit (Russia). Material — scrapings from the cervical canal. 11 146 women from the Gomel region were examined.

Results. According to the results of the studies, high-grade dysplasia (HSIL) was noted in 1.0% of cases, low-grade dysplasia (LSIL) — in 1.3% and atypical squamous cells of unknown significance (ASC-US) — in 1.8% of samples. A significant relationship between HPV and cervical dysplasia of varying degrees was established. In severe cervical dysplasia, HPV type 16 was identified in 69.2% of cases (p=0.027). In mild cases, type 45 was detected in 18% (p=0.001) and type 56 in 22.0% (p=0.010). The proportion of HPV 18 (18.5%) was significantly higher in the group of women with a normal cytogram (p < 0.001). No statistically significant differences in the frequency of occurrence of other HPV genotypes were found. In women of the Gomel region, with varying degrees of dysplasia, the dominance of HPV of the phylogenetic group a9 was noted, while in the group of women with HSIL, their share was maximum — 82.4%. HPV-associated dysplasia of the cervix was detected in 51% of women of reproductive age (p < 0.001).

Conclusion. The relationship between high-risk carcinogenic HPV and the development and progression of cervical intraepithelial dysplasia of the cervix has been demonstrated. It has been established that the genetic landscape of dominant HPV variants differs in women with different degrees of cervical dysplasia. Among women with cervical dysplasia, the dominance of HPV of the phylogenetic group a9 was noted, which was maximally represented in the group with HSIL. HPV screening and liquid cytology are important components of the program for early detection of neoplastic processes aimed at preventing cervical diseases caused by HPV.

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