Role of HPV 16 variants in cervical cancer samples from northeastern Brazil | BMC Women’s Health

According to our survey, the majority of women are in the age group of 40 to 49 years, self-reported with mixed races, attending primary school, and family incomes range from 1 to 2 times the minimum wage. At times, at a union that was married or agreed. There was no statistically significant association between sociodemographic variables and the presence of HPV.

Cervical cancer has low socioeconomic indicators, high poverty, high illiteracy, and high prevalence in areas with unstable sanitation practices. [15, 16]..

Study by Kings. (2015) [17] Women with a Pap smear tended to have higher levels of education to support the results of other studies, which may be related to lack of information and delayed search for treatments .. Manga et al. In a study conducted by. (2015) [18] The average age of 209 women seeking cervical cancer screening was 39.6 years, only 15% were unable to read and write, 88% were married, and 48% were paid. It was

In the tumor samples examined, the virus was highly prevalent (88 / 120–73%). The prevalence of HPV in invasive cervical cancer samples is 70-100% and may be related to various techniques used to detect the virus [19,20,21]..

HPV 16 is the most common cervical cancer in the world, followed by HPV 18. However, the frequency of HPV types can vary depending on the geographic region of the population analyzed. Other studies point out that types 16, 18, 31, and 45 are the four most prevalent HPV types in South and Central America [13, 21]..

A study to evaluate the role of intratype variants of HPV16 and HPV18 in the persistence of viral infection, the risk of cervical intraepithelial neoplasia, and the development of invasive cervical cancer [11, 13].. The distribution of subspecies around the world, both for HPV 16 and HPV 18, is influenced by geographical and ethnic factors.

According to the literature, HPV 16 variant A was the most common strain in the study population in the current study at San Luis de Maranhain. In a case-control study conducted by Hang et al. (2016) [5]In China, an attempt was made to assess the association between HPV 16 variant and cervical cancer risk in 298 women with HPV 16 and found that variant A predominates.

Volpini et al. In the survey conducted by (2017) [22] In Brazil, 24 HPV 16-positive women were diagnosed with HIV, but had abnormal Pap smear, variant A accounted for 70.8% (17/24), followed by variants C and D. , The total of samples is 29.2% (7/24).

In a study conducted in Brazil by Vidal et al. (2016) [12] In a cohort of 594 women with invasive cervical cancer, 334 women had HPV 16. Of these, 217 (65%) belonged to variant A and 97 (29%) belonged to variant D. Variants B and C are for 10 cases (3%) respectively.

Study by Villa et al. (2000) [23]In Brazil, we also investigated the association between geographical differences in HPV 16 intratypic variation and the occurrence of cervical cancer precursor lesions. Variant A (54%) was most frequent, followed by variant D in 22% of cases. It also highlights the strong association between persistence when compared to European prototype A and the presence of non-European variants B, C and D.

The most common histological type of HPV 16 tumors was 38 samples of squamous cell carcinoma (SCC). There was a statistically significant association between histology and HPV variants (p<0,001).

Staging has also changed in response to the HPV 16 variant. Among patients with variant A, stage III (9 patients) predominated.

Studies have also shown variations in the distribution of HPV types among histological types. HPV 16 is associated with squamous cell carcinoma and HPV 18 has a higher prevalence than HPV 16 in adenocarcinoma. However, few studies have attempted to identify an association between HPV 16 variants and histologic cervical tumors [24, 25]..

In research by hang etc. (2016) [5]In women with HPV 16-infected cervical cancer, 289 (97%) showed a pattern of squamous cell carcinoma followed by adenocarcinoma (2.3%) and adenosquamous cell carcinoma (0.7%). The pattern was seen.

The therapeutic response was also dependent on the HPV 16 variant. For example, 12 cases of variant A showed complete remission, whereas only 7 cases of variant D. Similarly, Variant A had 2 cases and Variant D had 3 cases. In 12 cases, the condition could not be evaluated. The end of the first treatment.

Tan et al. (2019) report that the European prototype E-T350 is the most popular (82.76%), followed by the Asia (As) variant. In patients with suspected cervical lesions, significance increased with severity of cervical disease, with the most common variant being the As variant (54.9%) [26]..

Another study conducted by Ortiz-Ortiz et al (2015) found that the more frequent mutations in women with cervical cancer were E-G350, AA-a, AA-c, E-C188/G350 and E. -It was A176 / G350. All of them were associated with the development of cervical cancer, but AA-a showed the highest association [27]..

Little research has been done to evaluate the effect of HPV 16 variants on response to tumor therapy. After analyzing 155 cases of HPV16-positive cervical cancer (132 cases of variant E × 23 cases of NE variant) Zuna et al (2011) [28] It was concluded that non-European subspecies behaved less aggressively than European subspecies in terms of mortality. It should be pointed out that due to the small number of NE variant cases in this study, caution should be exercised in assessing the data.

Our study found more NE variants (B, C, and D). Of 47 cases, 23 of variant A (E) and 24 of variants B, C, and D were found. Mortality in NE variant patients was 13% (3/24), compared to 9% (2/23) variant A (E). The number of cases with complete remission was also lower with the NE variant (33% x 52%). These findings can be explained by the large number of cases of variant D in our study (20 cases). Research by Burk et al (2013) [13], Showed specific aggression of this variant.

The subline A1 (21 cases) and the subline D3 (18 cases) were dominant. In a study by Hang et al (2016) [5], The A4 subline was associated with a significantly higher risk of cervical cancer than the A1-A3 subline (OR = 1.72, 95% CI).

Alfaro et al. , (2016) research [29] HPV 16 was identified in 50.9% of the 462 women with cervical cancer. Of these, the A1 2 (31.4%) subline was dominant, followed by the D2 (10.4%) and D3 (9.1%) subline. However, the AA variant accounted for 38.7% of HPV 16-positive cases.

A study by Nicolas-Parraga et al. (2017) [30], Aimed to investigate the prevalence of HPV 16 variants in cervical cancer patients in Europe, South and Central America, Asia, and Africa. 118 cases of squamous cell carcinoma, 120 cases of adenocarcinoma, and 53 cases of adenosquamous cell carcinoma were observed. The prevalence of HPV 16 was also highest in patients with squamous cell carcinoma. Examination of HPV 16 variants showed that A1-3 sublines were predominant in squamous cell carcinomas (76.9-97% by geographic region), and in adenocarcinoma there was a large variation in variant D depending on geographic region. (28.6-63.3% in different areas) geographical areas), and adenosquamous carcinoma (12.5-61.5% in different geographical areas).

The data also show that A1-3 in Europe (67.9-97% for all histotypes), Variant D in South Central America (61.5-63%, adenocarcinoma and squamous cell carcinoma), A4 in Asia ( 4) (11.5-27.6% for all types), Variants B and C in Africa (28-66.7% for ECC and ADC, 12.3-37.5%) [30]..