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Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study

Humane Papilloma Viren in hochgradigen zervikalen Dysplasien: Österreichische Daten einer europäischen multizentrischen Studie

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Summary

Background

The purpose is to present the Austrian data of an observational, cross-sectional, multicentre study conducted in 13 European countries. This study was undertaken to assess human papillomavirus (HPV) type distribution in high-grade cervical lesions.

Methods

Two hundred and ninety cases of high-grade cervical intraepithelial neoplasia (CIN2, CIN3) or adenocarcinoma in situ of the cervix from 2004 to 2007 were analysed by histopathological review and polymerase chain reaction for HPV.

Results

Two hundred and nine cases were “histologically eligible” and of those 206 were HPV+. Median age was 34 years (19–76 years). CIN3 was the most frequent diagnosis (64.6 %), followed by CIN2/3 (19.4 %) and CIN2 (13.6 %). Adenocarcinoma in situ was only detected together with a squamous lesion in 2.4 % cases. Majority of women (75.2 %) were infected with a single HPV type, 98.1 % of them with high-risk HPV types: HPV 16 (56.1 %), HPV 33 (12.3 %), HPV 31 (11.0 %), HPV 18 (3.9 %), HPV 35 (3.9 %), HPV 51 (3.2 %) and HPV 52 (2.6 %), HPV 58 (1.9 %) and HPV 45 (0.6 %). The low-risk HPV 6 was found in 1.3 % cases. Forty-six lesions (22.3 %) contained multiple infections, 71.1 % of those were HPV 16 or 18 and 91.1 % were HPV 16, 18, 31, 33 or 45 positive.

Conclusions

These Austrian data clearly demonstrate that HPV 16 is the predominant type in high-grade CIN, the immediate precursor lesions of cervical cancer. More than 60 % of the lesions were associated with HPV 16 and 18 and more than 85 % with HPV 16, 18, 31, 33 or 45. The prevalence of adenocarcinoma in situ is underestimated, since its detection is difficult with the current cytology screening.

Zusammenfassung

Grundlagen

Ziel dieser multizentrischen, in 13 europäischen Ländern durchgeführten Beobachtungsstudie ist die Erfassung der Typenverteilung von Humanen Papilloma Viren (HPV) in hochgradigen zervikalen Läsionen. Es werden die österreichischen Ergebnisse präsentiert.

Methodik

290 Fälle von hochgradigen zervikalen intraepithelialen Neoplasien (CIN2, CIN3) oder Adenocarcinoma in situ der Zervix wurden analysiert. Es wurden retrospektiv (von 2007–2004) zervikale Biopsiepräparate mit hochgradigen zervikalen Neoplasien sequentiell aus dem Archiv enthoben. Nach neuerlicher histopathologischer Prüfung erfolgte eine Testung auf HPV Desoxyribonucleinsäure mittels Polymerase Kettenreaktion.

Ergebnisse

209 Frauen bildeten die „histologisch auswertbare“ Kohorte, 206 waren HPV positiv. Das mittlere Alter war 34 Jahre (19–76). CIN3 war die häufigste histologische Diagnose (64,6 %), gefolgt von CIN2/3 (19,4 %) und CIN2 (13,6 %). Ein Adenocarcinoma in situ der Zervix wurde immer nur in Kombination mit einer hochgradigen Dysplasie diagnostiziert (2,4 %).

Die meisten Frauen waren mit einem HPV Typ infiziert (75,2 %), 98,1 % von diesen mit einem Hochrisiko-Typ: HPV 16 (56,1 %), HPV 33 (12,3 %), HPV 31 (11,0 %), HPV 18 (3,9 %), HPV 35 (3,9 %), HPV 51 (3,2 %) und HPV 52 (2,6 %), HPV 58 (1,9 %) und HPV 45 in 0,6 %. 46 Biopsate wiesen mehrere HPV Typen auf (22,3 %), 71,1 % davon HPV 16 oder 18 und 91,1 % HPV 16, 18, 31, 33 oder 45.

Schlussfolgerungen

HPV 16 ist der vorherrschende HPV Typ in hochgradigen zervikalen Neoplasien, der unmittelbaren Vorstufe des invasiven Zervixkarzinoms. Mehr als 60 % der Läsionen war mit HPV 16 und 18 assoziiert, mehr als 85 % mit HPV 16, 18, 31, 33 oder 45. Die Prävalenz des Adenocarcinoma in situ wird unterschätzt, da es mit den gängigen Screening Methoden schwer zu diagnostizieren ist.

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Authors and Affiliations

  1. Department of Gynaecology and Obstetrics, Comprehensive Cancer Center, Medical University of Vienna, Währingergürtel 18–20, 1090, Vienna, Austria

    Lucia Rössler & Elmar A. Joura MD

  2. Department of Gynaecology and Obstetrics, Medical University of Graz, Graz, Austria

    Olaf Reich

  3. Institute of Clinical Pathology, Medical University of Vienna, Vienna, Austria

    Reinhard Horvat

  4. GlaxoSmithKline Vaccines, 4 Clinics, Paris, France

    Sabrina Collas de Souza

  5. GlaxoSmithKline Vaccines, Wavre, Belgium

    Katsyarina Holl PhD

Authors
  1. Lucia Rössler
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  2. Olaf Reich
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  3. Reinhard Horvat
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  4. Sabrina Collas de Souza
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  5. Katsyarina Holl PhD
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  6. Elmar A. Joura MD
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Correspondence to Elmar A. Joura MD.

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Rössler, L., Reich, O., Horvat, R. et al. Human papillomavirus in high-grade cervical lesions: Austrian data of a European multicentre study. Wien Klin Wochenschr 125, 591–599 (2013). https://doi.org/10.1007/s00508-013-0403-6

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  • DOI: https://doi.org/10.1007/s00508-013-0403-6

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