Francesca M. Carozzi1, Maria L. Tornesello2, Elena Burroni1, Giovanna Loquercio2, Giuseppe Carillo3, Claudio Angeloni4, Aurora Scalisi5, Rosalba Macis6, Francesco Chini7, Franco M. Buonaguro2, Paolo Giorgi Rossi7 and for the HPV Prevalence Italian Working Group
Paolo Giorgi Rossi, Laziosanità, Via di Santa Costanza, 53, Rome 00198, Italy. E-mail: email@example.com
Background: The aim of this multicentric study was to identify human papillomavirus (HPV) type distribution in invasive cervical cancer and high-grade cervical intraepithelial neoplasia 2/3 (CIN2/3) in Italy.
Methods: Cases were sampled through the electronic databases at the pathology units of eight centers in six regions from central and southern Italy. HPV types were detected from paraffin-embedded tissue samples and cervical specimens through amplification of HPV DNA with GP5+/GP6+ primers, followed by genotyping with reverse line blot (RLB). Untyped HPV-positive samples were sequenced. HPV-negative samples underwent nested PCR, followed by either RLB or sequencing. Finally, the remaining HPV-negative samples were amplified with primers targeting the virus E6 to E7 regions.
Results: From 1,162 cases initially selected, 722 samples were further analyzed: 144 CIN2, 385 CIN3, 157 invasive squamous carcinomas, and 36 adenocarcinomas. Samples (6.9%) were HPV negative. The proportion of HPV16/18 was 60.8%, 76.6%, and 78.8% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.004). There was a significant decreasing trend of HPV16/18 with age in invasive cancers, going from 92% in women <35 years to 73% in women >55 years (P = 0.036). The proportion of coinfections was 16.8%, 15.5%, and 10.0% in CIN2, CIN3, and invasive cancers, respectively (P trend = 0.07).
Conclusions: The proportion of invasive cancers caused by HPV16/18 decreases with age at diagnosis.