title: High HPV-51 prevalence in invasive cervical cancers: results of a pre-immunization survey in North Sardinia, Italy.
abstract: BACKGROUND
  Human Papilloma virus (HPV) is recognized as the etiological agent of benign and malignant ano-genital lesions. The most prevalent genotypes associated with cervical carcinoma are HPV-16 and -18 worldwide. However, recent studies have emphasized the role of other genotypes, such as HPV-51, in the pathogenesis of cervical dysplasia. The aim of the study was to estimate the burden of HPV-51 infection in invasive cervical malignant lesions in Northern Sardinia, Italy.
  
  
  RESULTS
  An observational, retrospective, prevalence, mono-center study was carried out to evaluate the presence of HPV genotypes in tissues biopsies of cervical lesions (CIN-1, CIN-2, CIN-3 and invasive carcinoma) gathered from 1996 to 2009. Biological samples were collected from women admitted consecutively to a tertiary university hospital situated in Sassari, Italy. Molecular methods were used to identify 28 oncogenic HPV types. A total of 155 formalin-fixed and paraffin-embedded cervical tissue samples were analyzed. Approximately half of the cervical lesions were classified as invasive carcinoma. HPV-DNA was detected in 71% of the samples, with a higher frequency (100%) in those categorized as invasive neoplasia. Mono- or co-infections were demonstrated in 45.8% and 25.8% of the cervical samples, respectively. Overall, the most prevalent HPV types were -16 (49%) and -51 (19.4%), with an increased frequency of detection associated with the severity of the cervical lesions.
  
  
  CONCLUSIONS
  This survey highlights for the first time the relevant role of HPV-51 infection in the pathogenesis of invasive cervical cancer prior to the introduction of a vaccination program. Although a selection bias could have influenced the results, other recent studies have described the impact of HPV-51. This remarkable epidemiological element should be carefully evaluated, particularly in the view of opting for preventive vaccines, whose cross-protection patterns determine their efficacy in protecting against infection from HPV types that are not included in the vaccine itself.
authors.affiliation: Department of Biomedical Sciences, Hygiene and Preventive Medicine Unit, University of Sassari - AOU Sassari, Sassari, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Piana
authors.forename: Giovanni
authors.initials: G
authors.lastname: Sotgiu
authors.forename: Clementina
authors.initials: C
authors.lastname: Cocuzza
authors.forename: Rosario
authors.initials: R
authors.lastname: Musumeci
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Marras
authors.forename: Stefania
authors.initials: S
authors.lastname: Pischedda
authors.forename: Silvia
authors.initials: S
authors.lastname: Deidda
authors.forename: Elena
authors.initials: E
authors.lastname: Muresu
authors.forename: Paolo
authors.initials: P
authors.lastname: Castiglia
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D005838:Genotype; D006801:Humans; D007114:Immunization; D007558:Italy / Q000453:epidemiology; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000821:virology; D015995:Prevalence; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology / Q000235:genetics / Q000473:pathology / Q000821:virology
chemical_list: D004279:DNA, Viral