Unit:
Faculty of MedicineLibrary of the School of Health Sciences
Dissertation committee:
Τσακρής Αθανάσιος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Σπανάκης Νικόλαος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Καπαρός Γεώργιος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Πιτυρίγκα Βασιλική, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Αναστασοπούλου Κλειώ, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Δημητρούλια Ευαγγελία, Αναπληρώτρια Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Σιαφάκας Νικόλαος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Original Title:
Ανίχνευση του ιού των ανθρώπινων θηλωμάτων (HPV) στο γεννητικό σύστημα γυναικών στον ελληνικό πληθυσμό
Translated title:
Detection of human papillomavirus (HPV) in the female genital system in the Greek population
Summary:
In the effort to eliminate cervical cancer, a key contribution is the combination of extensive vaccination coverage of the young women population against the human papilloma virus (HPV) with the simultaneous use of sensitive molecular techniques (HPV DNA test-HPV mRNA test) for the reveal of high risk HPV infections. However, increased worldwide rates of precancerous lesions related to HPV types that are not included in the available vaccines, create the need to further investigate the prevalence of HPV types in the Greek female population and their participation in causing low-grade or high-grade precancerous lesions.
In a population of 253 women aged 18-65 living in Greece, a preventive cytological test for cervical cancer was performed using the co-testing method (PAP test and HPV DNA test of 41 types). Women with a positive HPV High Risk DNA test, regardless of the result of the Pap test, and women with a Pap test ≥ ASC-US, regardless of the result of the HPV DNA test, were led to a colposcopy and biopsy. In the samples of the women who had a positive HPV DNA test for one or more of the High Risk types 16, 18, 31, 33, 45, an HPV mRNA test was performed.
A high prevalence of High Risk HPV was observed (25.7% - 65 women). The high sensitivity of the HPV DNA test which led to identify 25 women with CIN I lesions compared to 15 women identified by the Pap test was highlighted, while both methodologies identified and referred for histological testing 2 women with CIN II lesions. The predominant type in CIN I-CIN II lesions by 36% was HPV 16. Second in prevalence in women with CIN I biopsy was HPV 51 by 24%, which ranked first among all High Risk HPVs that found in molecular testing at a rate of 25% and is not covered by the available vaccines. From the comparison of the results of co-testing in relation to the results of hypothetical alternative scenarios of primary screening, it appears that co-testing is superior if we set the detection of CIN I as the end point. The use of the mRNA test managed to identify the 2 cases with CIN II lesion and 13 of 25 cases with CIN I lesion.
Further research through larger epidemiologic studies and gynecologists’ vigilance is warranted until the potential of HPV 51 in causing high-grade lesions or cervical cancer is fully elucidated. The broad vaccination coverage with the 9V vaccine before the start of sexual life with the parallel use of molecular screening methodologies and the individualized approach and guidance of each woman will lead to the definitive elimination of cervical cancer in our country in the future.
Main subject category:
Health Sciences
Keywords:
HPV genotypes, Human papillomavirus, Cervical cancer, HPV vaccination, HPV51
Number of references:
153
File:
File access is restricted until 2026-04-03.
Kafasi Athanasia PhD.pdf
4 MB
File access is restricted until 2026-04-03.
