- Volume 16 Issue 15
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Type-Specific Human Papillomavirus Distribution in Invasive Squamous Cervical Carcinomas in Tunisia and Vaccine Impact
- Ennaifer, Emna (HPV Research Unit, Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases) ;
- Salhi, Faten (HPV Research Unit, Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases) ;
- Laassili, Thalja (HPV Research Unit, Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases) ;
- Fehri, Emna (HPV Research Unit, Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases) ;
- Alaya, Nissaf Ben (National Observatory of Novel and Emergent Diseases) ;
- Guizani, Ikram (HPV Research Unit, Laboratory of Molecular Epidemiology and Experimental Pathology Applied to Infectious Diseases) ;
- Boubaker, Samir (Department of Human and Experimental Pathology, Pasteur Institute of Tunis)
- Published : 2015.10.06
Background: High risk human papillomaviruses (HPVs) are the leading cause of cervical cancer (CC) and Pap smear screening has not been successful in preventing CC in Tunisia. HPV vaccination that targets HPV16 and 18 offers a new efficient prevention tool. Identification of HPV types in CC is thus essential to determine the impact of HPV vaccine implementation. The aim of this study is to provide specific data from Tunisia. Materials and Methods: A total of 89 histological confirmed paraffin embedded samples isolated from patients with CC diagnosed between 2001 and 2011 were collected from five medical centres from Northern and Southern Tunisia. HPV DNA was detected using a nested PCR (MY09/MY11-GP5+/GP6+) and genotyping was assessed using a reverse blot line hybridisation assay that enables the detection of 32 HPV types. Results: HPV DNA was detected in all samples. Twelve high risk types were detected; HPV16 and/or 18 were predominant, accounting together for 92.1% of all the CC cases (HPV16: 83.1%). Single infections accounted for 48.8% of the cases and were mostly linked to HPV 16 (32.6%) and less frequently to HPV 18 (2.4%). The other high risk HPV single infections were linked to HPV 35 (4.6%), 45 (4.6%), 58 (2.3%) and 59 (2.3%). Multiple infections with mixing of 2 to 4 genotypes predominately featrued HPV16 and/or 18 with HPV 35 and 45 (96.6 %) and less frequently with HPV 59, 40, 66, 73 and 58. There was no statistically significant variation in the relative distribution of HPV types with age. Conclusions: These results strongly indicate that prophylactic HPV vaccines can have a major impact in preventing CC in Tunisia.
Supported by : Ministry of Technology and Scientific
- Abdul Raub SH, Isa NM, Zailani HA, et al (2014) Distribution of HPV Genotypes in Cervical Cancer in Multi-ethnic Malaysia. Asian Pac J Cancer Prev, 12, 645-8.
- Ben Abdallah M, Zehani S, Hizem Ben Ayoub W (2009). Registre des Cancers Nord-Tunisie.
- Benerini Gatta L, Cadei M, Balzarini P, et al (2012) Application of alternative fixatives to formalin in diagnostic pathology. Eur J Histochem, 56, 12.
- Cancer incidence in Five Continents, vol. IX. (2007). in "the Narratives and the Maps, Africa" Eds Curado.M.P, Edwards, B, Shin H.R., Storm H et al. WHO Press. Switzerland pp 107 Numbers 160 IARC Scientific Publications
- Carvalho Nde O, del Castillo DM, Perone C, et al (2010). Comparison of HPV genotyping by type-specific PCR and sequencing. Mem Inst Oswaldo Cruz, 105, 73-8. https://doi.org/10.1590/S0074-02762010000100011
- C Kitchener H, Canfell K, Gilham C, et al (2014). The clinical effectiveness and cost-effectiveness of primary human papillomavirus cervical screening in England: extended follow-up of the ARTISTIC randomised trial cohort through three screening rounds. Health Technol Assess, 18, 1-196.
- Chaouki N, Bosch FX, Munoz N, et al (1998). The viral origin of cervical cancer in Rabat, Morocco. Int J Cancer, 75, 546-54. https://doi.org/10.1002/(SICI)1097-0215(19980209)75:4<546::AID-IJC9>3.0.CO;2-T
- Clifford GM, Smith JS, Plummer M, Munoz N, Francheschi S (2003). Human papillomavirus types in invasive cervical cancer worldwide: a meta-analysis. British Journal of Cancer, 88, 63-73 https://doi.org/10.1038/sj.bjc.6600688
- Clifford G, Franceschi S, Diaz M, Munoz N, Villa LL (2006) Chapter 3: HPV type-distribution in women with and without cervical neoplastic diseases. Vaccine, 31, 26-34.
- Cogliano V, Baan R, Straif K, et al (2005). WHO International Agency for Research on Cancer. Carcinogenicity of human papillomaviruses. Lancet Oncol, 6, 204. https://doi.org/10.1016/S1470-2045(05)70086-3
- De Roda Husman AM, Walboomers JM, van den Brule AJ, Meijer CJ, Snijders PJ (1995). The use of general primers GP5 and GP6 elongated at their 3' ends with adjacent highly conserved sequences improves human papillomavirus detection by PCR. J Gen Virol, 76, 1057-62. https://doi.org/10.1099/0022-1317-76-4-1057
- De Sanjose S, Quint WG, et al (2010). Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide. Lancet Oncol, 11, 1048-56. https://doi.org/10.1016/S1470-2045(10)70230-8
- Eklund C, Zhou T, Dillner J. WHO Human Papillomavirus Laboratory Network (2010). Global proficiency study of human papillomavirus genotyping. J Clin Microbiol, 48, 4147-55 https://doi.org/10.1128/JCM.00918-10
- Fattorini P, Marrubini G, Ricci U, et al ( 2009). Estimating the integrity of aged DNA samples by CE Electrophoresis, 30, 3986-95. https://doi.org/10.1002/elps.200900283
- Ferlay J, Shin HR, Bray F, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 127, 2893-917. https://doi.org/10.1002/ijc.25516
- Hammouda D, Munoz N, Herrero R, et al (2005). Cervical carcinoma in Algiers, Algeria: human papillomavirus and lifestyle risk factors. Int J Cancer, 113, 483-9. https://doi.org/10.1002/ijc.20600
- Harper DM, Franco EL, Wheeler CM, et al (2006). Sustained efficacy up to 4.5 years of a bivalent L1 virus-like particle vaccine against human papillomavirus types 16 and 18: follow-up from a randomised control trial. Lancet, 367, 1247-55. https://doi.org/10.1016/S0140-6736(06)68439-0
- Hsairi M, Fakfakh R, Bellaaj R, Achour N (2003). Attitude to cervical cancer screening of women residing in two regions of northern Tunisia. Tunis Med, 81,721-30.
- Human papillomavirus vaccines. WHO position paper (2009). Wkly Epidemiol Rec, 84, 118-31.
- KrennHrubec K, Mrad K, Sriha B, et al ( 2011). HPV types and variants among cervical cancer tumors in three regions of Tunisia. J Med Virol, 83, 651-7. https://doi.org/10.1002/jmv.22011
- Kulkarni SS , Kulkarni SS, Vastrad P P, et al ( 2011). Prevalence and distribution of high risk human papillomavirus. (HPV) Types 16 and 18 in carcinoma of cervix, saliva of patients with oral squamous cell carcinoma and in the general population in karnataka, India. Asian Pac J Cancer Prev, 12, 645-8
- Lazzar BG, Hajjem S, Aounallah-Skhiri H, Achour N, Hsairi M (2011). Mortality from cancer in Tunisia: calculating years of life lost. Sante Publique, 23, 31-40
- Lee SH (2012). Guidelines for the use of molecular tests for the detection and genotyping of human papilloma virus from clinical specimens. Methods Mol Biol, 903, 65-101. https://doi.org/10.1007/978-1-61779-937-2_5
- Longy M, Duboue B, Soubeyran P, Moynet D (1997). Method for the purification of tissue DNA suitable for PCR after fixation with Bouin's fluid. Uses and limitations in microsatellite typing. Diagn Mol Pathol, 6, 167-73. https://doi.org/10.1097/00019606-199706000-00007
- Mc Sherry EA, Mc Goldrick A, Kay EW (2007). Formalin-fixed paraffin-embedded clinical tissues show spurious copy number changes in array-CGH profiles. Clin Gen, 72, 441-7. https://doi.org/10.1111/j.1399-0004.2007.00882.x
- Missaoui N, Hmissa S, Trabelsi A, et al (2010). Prevalence of HPV infection in precancerous and cancerous lesions of the uterine cervix in Tunisia. Ann Biol Clin, 68, 297-303.
- Munoz N, Bosch FX, Castellsague X, et al (2004).Against which human papillomavirus types shall we vaccinate and screen? The international perspective. Int J Cancer, 111, 278-85. https://doi.org/10.1002/ijc.20244
- Njah M, Ben Ahmed S, Marzouki M (1994). Cancer of the breast and uterine cervix: knowledge level and preventive practices in a segment of the Tunisian population. Sante, 4, 299-302.
- Paavonen J, Naud P, Salmeron J, et al (2009). Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet, 374, 301-14. https://doi.org/10.1016/S0140-6736(09)61248-4
- Shen XH, Liu SH (2013). Human papillomavirus genotypes associated with mucopurulent cervicitis and cervical cancer in hangzhou, China. Asian Pacific J Cancer Prev, 14, 3603-6. https://doi.org/10.7314/APJCP.2013.14.6.3603
- Sjoeborg KD, Trope A, Lie AK, et al (2010). HPV genotype distribution according to severity of cervical neoplasia. Gynecol Oncol, 118, 29-34. https://doi.org/10.1016/j.ygyno.2010.03.007
- Villa LL, Costa RL, Petta CA, et al (2006). High sustained efficacy of a prophylactic quadrivalent human papillomavirus type 6:11:16:18 L1 virus like particle vaccine through 5 years of follow up. Br J Cancer, 95, 1459-66. https://doi.org/10.1038/sj.bjc.6603469
- Walboomers JM, Jacobs MV, Manos MM,, et al (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Patho, 189, 12-9. https://doi.org/10.1002/(SICI)1096-9896(199909)189:1<12::AID-PATH431>3.0.CO;2-F
- Webersinke C, Doppler S, Roithmeier F, Stummvoll W, Silye RJ (2013). Cervical biopsies and cytological smears - A comparison of sample materials in HPV diagnostics. Clin Virol, 56, 69-71. https://doi.org/10.1016/j.jcv.2012.09.008
- World Health Organization (2009): Human papillomavirus laboratory manual. 1st eds Unger E. R, Dillner J, Zhou T . Geneva, Switzerland..
- The frequency of Human Papillomavirus Genotypes in Invasive Cervical Cancer of Romanian Patients vol.25, pp.2, 2017, https://doi.org/10.1515/rrlm-2017-0008