Prevalence of HPV 16/18 Subtypes Among Invasive Cervical Cancer Patients from a Tertiary Care Hospital in South India: A
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ORIGINAL ARTICLE
Prevalence of HPV 16/18 Subtypes Among Invasive Cervical Cancer Patients from a Tertiary Care Hospital in South India: A Cross-Sectional Study Niranjan Vijayaraghavan1
•
K. V. S. Latha1 • T. S. Rahul1 • Sivasubramaniam Kumaravelu1
Received: 4 August 2020 / Revised: 13 September 2020 / Accepted: 18 September 2020 Ó Association of Gynecologic Oncologists of India 2020
Abstract Purpose To find out the proportion of HPV sub types 16 & 18 in invasive cervical carcinoma. Methods This is a prospective observational study performed on 100 women with invasive cervical cancer. RT PCR was performed on the DNA extracted from the punch biopsy using RNA primers specific for subtypes 16 and 18. Results The mean age of the population was 53.25 years. The mean age of coitus was 19.25 years. Around 70% of the patients belong to class 4 or above socioeconomic status. The most common presenting symptom was vaginal discharge seen in 40% of the cases. The most common stage was stage IIB (40%) followed by IIIB (22%). 52% of the population had Grade 3 disease. In our study, the proportion of HPV-positive cancer was 64%. 60% of the patients were positive for HPV 16 subtype, and 22% were positive for HPV 18 subtypes. 18% were positive for both HPV 16 and 18. All stage IV A and IV B patients had HPV positivity. Conclusion Around two-third of the cervical cancer are attributed to high-risk HPV 16 and 18. Bivalent vaccine can reduce a significant proportion of cases in our country. Keywords HPV 16 HPV 18 Prevalence Carcinoma Cervix
Introduction As per the GLOBOCAN 2018 data, cervical cancer is the 4th most common cancer and also 4th most common cause of cancer-related deaths worldwide [1]. In India, it ranks second most common cancer. Nearly 85 to 90% of all invasive cervical cancer are associated with HPV [2]. The E6, E7 viral oncoproteins of HPV bind to p53 and Rb protein, respectively. E7 protein releases E2F and results in
cell cycle progression at G1 S phase [3]. The E6 protein binds to p53 and degrades it [4]. As a result, there is loss of G1 S arrest, apoptosis, DNA repair resulting in malignant transformation of a normal cell [5]. There are 18 high-risk subtypes of HPV namely: type 16, 18, 26, 31, 33, 35, 39, 45, 51, 52, 53, 56, 58, 59, 66, 68, 73, and 82. Among the high-risk types, HPV 16 and 18 account for 50% and 20% of the cervical cancer worldwide [2, 6]. We performed this study to estimate prevalence of high-risk HPV subtypes 16 and 18 infections among patients with invasive cervical cancer attending the medical oncology department.
& Niranjan Vijayaraghavan [email protected] K. V. S. Latha [email protected]
Methodology
T. S. Rahul [email protected]
From January 2019 to December 2019, 100 women with biopsy proven invasive cervical cancer stage IB to IVB were included in the study. Patients with history of treated invasive cervical cancer and who didn’t give an informed written consent were excluded. The study was approved by the Institute Ethical Committee. Their baseline
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