title: Type-specific human papillomavirus distribution in invasive cervical carcinomas in Paraguay. A study of 432 cases.
abstract: Cervical carcinoma is the most common malignant tumor among woman in Paraguay. Cytological screening programs have not been successful and a plan for human papillomavirus (HPV) based-screening program and/or vaccination is under evaluation. This study aimed to identify the contribution of HPV genotypes in invasive cervical cancer in Paraguay to provide essential background data to guide and assess the introduction and impact of new preventive strategies based on HPV. Four hundred thirty two histologically confirmed cases (1960-2004) were analyzed. HPV detection in paraffin blocks was performed at the Catalan Institute of Oncology using PCR with SPF-10 broad spectrum primers followed by DNA enzyme immunoassay and genotyping with a reverse hybridization line probe analysis. The majority of cases were squamous cell carcinoma (92.8%). Mean patients age was 48 years old. HPV DNA was detected in 73.1% of the cases and single infections were predominant (97.8%). The most common HPV single types were 16, 18, 45, 33, 31, 52, 35, and 39. 73.1% of HPV positive cases had an HPV 16, 18 as single infection. HPV16 was frequent in SCC whereas HPV 18 and 45 were prevalent in glandular tumors. Significant decrease of HPV 16 with age groups (P-trend = 0.022) and increase in other HPV types (P-trend > 0.001) were observed. The potential impact of HPV 16 and 18 for a vaccination program was 73.1%. The study provide a profile of the HPV situation in the country, with robust clinical, pathological and virological data which would permit a better cervical cancer screening and vaccination programs.
authors.affiliation: Health Sciences Research Institute, IICS, National University of Asunción, Asunción, Paraguay. ekasabalbo@gmail.com
authors.forename: Elena
authors.initials: E
authors.lastname: Kasamatsu
authors.forename: Antonio L
authors.initials: AL
authors.lastname: Cubilla
authors.forename: Laia
authors.initials: L
authors.lastname: Alemany
authors.forename: Alcides
authors.initials: A
authors.lastname: Chaux
authors.forename: Sara
authors.initials: S
authors.lastname: Tous
authors.forename: Laura
authors.initials: L
authors.lastname: Mendoza
authors.forename: Malvina
authors.initials: M
authors.lastname: Paez
authors.forename: Jo Ellen
authors.initials: JE
authors.lastname: Klaustermeier
authors.forename: Wim
authors.initials: W
authors.lastname: Quint
authors.forename: Belen
authors.initials: B
authors.lastname: Lloveras
authors.forename: Silvia
authors.initials: S
authors.lastname: de Sanjose
authors.forename: Nubia
authors.initials: N
authors.lastname: Muñoz
authors.forename: Francisco Xavier
authors.initials: FX
authors.lastname: Bosch
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D003430:Cross-Sectional Studies; D017931:DNA Primers / Q000235:genetics; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D017720:Molecular Epidemiology; D009693:Nucleic Acid Hybridization; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D010239:Paraguay / Q000453:epidemiology; D016133:Polymerase Chain Reaction; D002583:Uterine Cervical Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000821:virology*; D055815:Young Adult
chemical_list: D017931:DNA Primers; D004279:DNA, Viral