Human Papillomavirus Genotype Distribution and E6/ E7 Oncogene Expression in Turkish Women with Cervical Cytological Findings

Abstract

<b>Background:</b> Infection with certain human papillomavirus (HPV) genotypes is the most important riskfactor related with cervical cancer. The objective of the present study was to investigate the prevalence of HPVinfection, the distribution of HPV genotypes and HPV E6/E7 oncogene mRNA expression in Turkish women withdifferent cervical cytological findings in Mersin province, Southern Turkey. Materials and <br/><b>Methods</b>: A total of476 cytological samples belonging to women with normal and abnormal cervical Pap smears were enrolled in thestudy. For the detection and genotyping assay, a PCR/direct cycle sequencing approach was used. E6/E7 mRNAexpression of HPV-16, 18, 31, 33, and 45 was determined by type-specific real-time NASBA assay (NucliSENSEasyQ®HPV v1.1). <br/><b>Results</b>: Of the 476 samples, 106 (22.3%) were found to be positive for HPV DNA by PCR.The presence of HPV was significantly more common (p<0.001) in HSIL (6/8, 75%) when compared with LSIL(6/14, 42.9%), ASC-US (22/74, 29.7%) and normal cytology (72/380, 18.9%). The most prevalent genotypes were,in descending order of frequency, HPV genotype 66 (22.6%), 16 (20.8%), 6 (14.2%), 31 (11.3%), 53 (5.7%), and83 (4.7%). HPV E6/E7 oncogene mRNA positivity (12/476, 2.5%) was lower than DNA positivity (38/476, 7.9%).<br/><b>Conclusions</b>: Our data present a wide distribution of HPV genotypes in the analyzed population. HPV genotypes66, 16, 6, 31, 53 and 83 were the predominant types and most of them were potential carcinogenic types. Becauseof the differences between HPV E6/E7 mRNA and DNA positivity, further studies are required to test the roleof mRNA testing in the triage of women with abnormal cervical cytology or follow up of HPV DNA positive andcytology negative. These epidemiological data will be important to determine the future impact of vaccinationon HPV infected women in our region.