VALUTAZIONE DELLA COMPRESENZA DEL PAPILLOMAVIRUS (HPV) IN SEDE ORALE E GENITALE IN DONNE CON CITOLOGIA CERVICALE POSITIVA E NEI RISPETTIVI PARTNER
Tesi di Dottorato
Data di Pubblicazione:
2017
Citazione:
VALUTAZIONE DELLA COMPRESENZA DEL PAPILLOMAVIRUS (HPV) IN SEDE ORALE E GENITALE IN DONNE CON CITOLOGIA CERVICALE POSITIVA E NEI RISPETTIVI PARTNER / G. Cossellu ; tutor: G. Farronato ; coordinatore: M. Del Fabbro. DIPARTIMENTO DI SCIENZE BIOMEDICHE, CHIRURGICHE ED ODONTOIATRICHE, 2017 Feb 23. 29. ciclo, Anno Accademico 2016. [10.13130/cossellu-gianguido_phd2017-02-23].
Abstract:
Introduction/Objective
The human papilloma viruses (HPVs) are DNA viruses associated with benign and malignant
lesions.
For gynaecologists, the carcinogenic potential and the necessity of HPV presence for the
development of cancer has been understood for decades in relation to the cervix uteri, and for a
large portion of other anogenital tumours.
The HPVs have been studied in last decades also by many other different specialist due to its role
in association with numerous different cancers in several tissues including Head and neck squamous
cell cancer (HNSCC) and Oral Squamous Cell Carcinoma (OSCC).
HNSCC accounts for more than 7 % of all human cancer types. Despite the development of new
surgical techniques and the introduction of multidisciplinary treatments still almost half of the
patients decease. For a long time period smoking and alcohol were the main risk factors
contributing to HNSCC. Even if a decline in smoking has been registered from '70s till now, the
incidence of OSCC is still rising. This might be explained by an increasing of HPV positive tumors.
For this reason the women’s HPV-positive cervix is discussed to act as a virus reservoir. However,
until today it remains unclear if the women’s HPV-positive cervix uteri really serves as a virus
reservoir and if certain sexual practices are the cause for HPV transmission to the oropharynx.
Data on genotype-specific concordance of oral-oral and genital-oral HPV infections among
heterosexual couples are key to understand HPV transmission between partners.
This study aimed at assessing the concurrence of oropharyngeal HPV infection, with relative
genotyping, in women with cervical lesions and in their current stable sexual partners in an Italian
population.
Material and methods
105 female subjects with a positive PAP test were enrolled in this study.
Complete datas, cervical brush, oral swab, oral rinse and urine (only male) samples were collected
from 44 women and 28 men. Demographic and behavior data were obtained through a structured
questionnaire.
HPV-DNA amplification was performed by polymerase chain reaction assay (PCR) using both
primers MY09/MY11 and FAP59/64. HPV genotyping has been performed with Sanger technique
and each sequence compared with the Finch software and "The PapillomaVirus Episteme" (PaVE)
database.
Positive samples have been analyzed also with the Inno-Lipa Genotyping Extra kit in order to have
an higher accuracy in case of multiple genotype infections.
Different variables were considered for the statistical analyses: gender, age, number of partners, oral
sex, alcohol consumption per week, lesions etc. The effect of the variables on the HPV infection
status was assessed, by fitting a generalized model, using the GLM (General Linear Model)
function in R software. The family “binomial” was used for the description of the error distribution
and link function. The function fisher test was used to perform Fisher’s exact test as a verification
test. The model was tested using the maximum likelihood to evaluate the effect of the inclusion of
each parameter to the model. As a supplementary analysis, the correlations were calculated between
all parameters.
Results
86% of cervical samples were HPV-positive. Different genotypes have been isolated (i.g. 6, 66, 39,
16, 31, 56, 42, 58, 114, 59, 61, 68, 45, 35, 33 e 53, 89, 114).
20% of the oral samples were positive in the female group and 25% in the male one.
Only one sample of urine was positive and the same HPV genotype has been found in the cervical
brush of his female partner.
No other specific genotype concordance has been found between female and male couples.
The regression of the variables against the total infection status highlighted three si
Tipologia IRIS:
Tesi di dottorato
Keywords:
HPV ; Human Papilloma Virus ; Oral Cancer ; Cervical Cancer ; Oropharyngeal squamous cell cancer ; Transmission ; head and neck cancer ; genotype
Elenco autori:
G. Cossellu
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