| Abstract | Cilj: Cilj rada bio je istražiti povezanost nalaza humanog papiloma virusa testiranjem na HPV 16 genotip, HPV 18 genotip te na grupu ostalih visokorizičnih HPV genotipova s citološkim nalazom papa testa žena koje sudjeluju u probiru, obradi i praćenju lezija vrata maternice, te usporediti podatke o praćenju i ishodu bolesti. Materijali i postupci: Retrospektivno su analizirani rezultati 2916 pacijentica čiji su testovi na HPV visokog rizika i papa testovi obrađeni u Kliničkom bolničkom centru Rijeka u periodu od 6. svibnja 2019. godine do 2. veljače 2021. godine. Pacijentice su bile praćene u trajanju od 1 do 18 mjeseci. Rezultati: Najveći broj pacijentica bio je pozitivan na OHR HPV (21,23%), a potom na HPV 16 (4,66%) i HPV 18 (1,68%), a 3,6% pacijentica bilo je pozitivno na više tipova HPV-a. Učestalost HSIL+ ishoda bila je statistički značajno veća u grupi HPV pozitivnih žena nego u grupi HPV negativnih (21,78% vs. 0,55%; P<0,0001). Također, u podskupini HPV 16 i 18 pozitivnih žena bilo je statistički značajno više HSIL+ ishoda nego kod OHR HPV pozitivnih žena (35,52% vs. 15,35%, P<0,0001). Nije pronađena statistički značajna razlika u prevalenciji genotipova 16 i 18 između žena mlađih i starijih od 30 godina niti u jednoj skupini nalaza papa testa. Kotestiranje je pokazalo osjetljivost od 100%, ali specifičnost od 59%. Zaključak: Istraživanje je dokazalo važnost trijažnog HPV testiranja kod ASCUS i LSIL nalaza te važnost parcijalne genotipizacije u predviđanju HSIL ishoda, ali i važnost ostalih visokorizičnih tipova HPV-a u nastanku lezija visokog stupnja. Kotestiranje bi trebalo imati prednost nad korištenjem HPV testiranja kao jedinog primarnog testa u probiru, s obzirom na veću osjetljivost. |
| Abstract (english) | Aim: The aim of this study was to evaluate the association of human papillomavirus by HPV 16 genotype, HPV 18 genotype and other high-risk HPV genotypes with cytological findings of Pap smear in women participated in screening, management and follow-up of cervical cytological abnormalities, and compare results of follow-up and outcomes of disease. Materials and methods: The results of 2916 patients whose high-risk HPV tests and pap tests were processed at the Clinical Hospital Center Rijeka from May 6, 2019 to February 2, 2021 were retrospectively analyzed. Follow-up period was between 1 and 18 months. Results: The most of the patients was positive for OHR HPV (21.23%), followed by HPV 16 (4.66%) and HPV 18 (1.68%), and 3.6% of patients were positive for more than one type of HPV. The prevalence of HSIL + outcomes was statistically significantly higher in HPV-positive women than in HPV-negative women (21.78% vs. 0.55%; P <0.0001). Also, there were statistically significantly more HSIL + outcomes in HPV 16 and 18 positive women than in the OHR HPV positive women (35.52% vs. 15.35%, P <0.0001). No statistically significant difference was found in the prevalence of genotypes 16 and 18 between women younger and older than 30 in any group of pap test findings. Cotesting showed a sensitivity of 100% but a specificity of 59%. Conclusion: The study proved the importance of triage HPV testing in ASCUS and LSIL findings and the importance of partial genotyping in predicting HSIL outcome, but also the importance of other high-risk HPV types in the development of high-grade lesions. Co- testing should be prefered over the HPV primary screening strategy, due to the greater sensitivity |
