Fatimah S. Alhamlan (Saudi Arabia)
King Faisal Specialist Hospital and Research Centre Infection and ImmunityPresenter of 1 Presentation
PROGNOSTIC IMPACT OF HUMAN PAPILLOMAVIRUS INFECTION ON CERVICAL DYSPLASIA, CANCER, AND PATIENT SURVIVAL: A 10-YEAR RETROSPECTIVE ANALYSIS IN SAUDI ARABIA (ID 11)
Abstract
Introduction
Cervical cancer is caused by persistent human papillomavirus (HPV) infection. However, HPV prevalence data and survival rates among HPV-infected women are scare in Saudi Arabia. This study assessed the prevalence of HPV genotypes between 2006 and 2016 and determined whether HPV presence predicted cervical dysplasia classification, cervical cancer, or survival among women attending a Saudi referral hospital.
Methods
Cervical biopsy specimens underwent HPV detection using PCR, HPV viral load quantification using quantitative real-time PCR, HPV genotyping using GenoFlow array testing, and tumor suppressor protein p16INK4a expression measurement using immunohistochemistry. Kaplan-Meier plots were constructed to analyze overall survival rates and to assess survival based on age, HPV presence, cervical dysplasia, and cervical cancer.
Results
Of the 316 cervical specimens examined, HPV was detected in 96 (30.4%); 37% had cervical cancer; 14% cervical intraepithelial neoplasia (CIN) III, 5% CIN II, and 17% CIN I. The two most common types detected were HPV-16 (56.2%) and HPV-18 (8.3%). A significant association was found between HPV-16 viral load and disease progression (P < .001, Mann-Whitney U) and between HPV presence and cervical cancer (χ2, 56.78; P < .001). HPV status was a significant predictor of survival: HPV-negative women had poorer survival rates than HPV-positive women (multivariate Cox regression, hazard ratio, 7.04; 95% CI, 2.03-24.45). In addition, overexpression of p16INK4a was correlated with the severity of histologic abnormality (log-rank test, P = .049).
Conclusions
These findings suggest that implementing cervical cancer and HPV screening programs will decrease cervical cancer rates and improve survival rates of women in Saudi Arabia.