Correlation between abnormal cytological findings and human papillomavirus infection of the uterine cervix in Bulgarian women

Abstract

The aim of this study was to analyse the correlation between cases of human papillomavirus (HPV+/−) infection of the uterine cervix revealed through HPV typing and cytological results from Papanicolaou (Pap)-stained cervical smears. Cervical smears of 421 Bulgarian women attending routine gynaecological examinations during the three-year study period were stained by the Pap technique and classified by the Bethesda system. GenoFlow HPV Array Test Kit was used to analyse the HPV status in the collected cervical samples. The results showed that, of the 421 women, 177 (42%) were HPV(+) and 244 (58%) were HPV(−); 334 (79.3%) Pap smears were with normal morphology and 87 (20.7%) had high/low grade squamous intraepithelial lesion (LSIL/HSIL) changes. Of the 87 women with LSIL/HSIL changes, 54% (47/87) were HPV(−) and 46% (40/87) were HPV(+). There was no statistically significant correlation between the HPV(+) status and the cytological LSIL/HSIL findings (P > 0.05). Koilocytes were found in 30.4% (128/421) of the samples. Of the 128 women with koilocytosis, 59.4% (76/128) were HPV(−) and 40.6% (52/128) were HPV(+). There was no significant correlation (P > 0.05) between the presence of koilocytes in cervical smears and HPV infection. Our results suggest that HPV infection is frequent even in women with negative Pap-smear results, and polymerase chain reaction seems to be the only reliable test to diagnose this infection. However, the results from this study cannot be considered to fully support the replacement of cytology and colposcopy examination in cervical cancer screening with HPV genotyping tests only.

Keywords

• HPV
• infection
• Pap findings
• HSIL
• LSIL