Identification of Human Papillomavirus in Women with Genital Warts by PCR and Pap Smear in Sari
,
Abstract
Background: The most significant genital lesion caused by HPV infection is genital warts, which are benign. The importance of genital warts relates to cervical cancer risk factors. In fact, this virus has been identified as the cause of 99% of cervical cancers worldwide, necessitating non-invasive methods for disease management. Identifying an appropriate, accurate, and highly sensitive screening method is crucial. Therefore, we investigated the diagnosis of papillomavirus in women with genital warts using Pap smear and PCR.
Methods: From September 2019 to August 2020, 41 vaginal swab and cervical samples from females with genital warts were assessed for HPV DNA detection by PCR and Pap smear.
Results: Among 41 vaginal swab specimens from those with genital warts, 5 cases (12.12%) were detected by molecular method, while Pap smear analysis of the same 41 samples revealed 8 cases (19.5%) of abnormal findings, including 2 cases of ASC (4.9%), 6 cases (14.6%) of metaplastic cells, and 33 cases (80.4%) normal results, comprising 11 inflammatory cases (26.8%) and 22 normal cases (53.7%).
Conclusion: The incidence of HPV infection in females with genital warts was 12.12% by PCR. However, conventional Pap smear screening detected 19.5% cervical dysplasia cases attributable to papillomavirus infection. The discrepancy between PCR and Pap smear results stems from the specificity and low sensitivity of the Pap smear method. Therefore, it is recommended to use the PCR diagnostic method alongside Pap smear to enhance screening quality in individuals with genital warts.
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12. Ghobadi M, Bashi Zadeh Fakhar H, Shaghaghi B. The prevalence of human papillomavirus genotypes in women with genital warts using polymerase chain reaction (PCR). Int J Cancer Manage 2023; 16(1):e131234.
13. Tabeshian A, Firoozeh F. The effect of health education in performing pap smear for prevention of cervix cancer in teachers of Esfehan city. J Azad Univ Tehran Med Branch 2009; 19(1):35-40.
14. Jemal A, Bray F, Center MM, et al. Global cancer statistics. Cancer J Clin 2011; 61(2):69-90.
15. Sachan P, Singh M, Patel M, et al. A study on cervical cancer screening using pap smear test and clinical correlation. Asia-Pacific J Oncol Nursing 2018; 5(3):338-41.
16. Ghanbari F, Bashi Zadeh Fakhar H, Alamian S, et al. Comparative evaluation of serological, elisa and molecular tests in diagnosis of Brucella abortus in human serum. J Med Bacteriol 2023; 12(1-2):45-52.
17. Jones HW. Nowak's Gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 1996. p. 453-65.
18. Jaberipour M, Samsami A, Sahraiian F, et al. Elevation of HPV-18 and HPV-16 DNA in the plasma of patients with advanced cervical cancer. Asian Pacific J Cancer Prevent 2011; 12:163-7.
19. Esmaeili M, Bonyadi M, Dastranj A, et al. HPV typing in women with cervical precancerous and cancerous lesions in north-western Iran. Gyn Obs Invest 2008; 66(1):68-72.
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24. Bidaki MZ, Zardast M, Semnani AN, et al. Investigation of frequency and typing of human papillomavirus among genital warts using a reverse dot blot hybridization approach. BMC Infect Dis 2022; 22:278.
25. Lannér L, Kristina A, Lindström A. Incidence of HPV and HPV related dysplasia in elderly women in Sweden. PLoSOne 2020; 15(3):e0230151.
26. Verma A, Verma S, Vashist S, et al. A study on cervical cancer screening in symptomatic women using Pap smear in a tertiary care hospital in rural area of Himachal Pradesh, India. Middle East Fert Soc J 2017; 22:39-42.
27. Padmini CP, Indira N, Chaitra R, et al. Cytological and colposcopic evaluation of unhealthy cervix. J Evid Based Med Healthcare. 2015; 2(42):6920-7.
28. Gupta SM, Warke H, Chaudhari H, et al. Human papillomavirus E6/E7 oncogene transcripts as biomarkers for the early detection of cervical cancer. J Med Virol 2022; 94(1):1-8.
29. Mijthab N, Saadoon I, Almola E, et al. Relation of HPV genotyping by PCR to cervical Pap smear results in women with genital warts. Med J Tikrit Univ 2018; 24(2):104-12.
30. Brink AA, Snijders PJ, Meijer CJ. HPV detection methods. Dis Markers 2007; 23(4):273-81.
31. Trieu ST, Tran KV, Nguyen TT, et al. Detection and genotyping of the human papillomavirus in Vietnam. Nat Vol Essen Oils 2021; 8(4):11154-63.
32. Saiki Y, Gion Y, Nishikori A, et al. Comparison of the hybrid capture ii method with a pcr-based screening method using a carboxyfluorescein-labeled primer for detecting human papillomavirus in cervicovaginal liquid-based cytology. J Mol Path 2020; 1(1):9-18.
33. Allan BR, Marais DJ, Denny L, et al. The agreement between cervical abnormalities identified by cytology and detection of high-risk types of human papillomavirus. South African Med J 2006; 96(11):1186-90.
34. Maleki A, Ahmadnia E, Avazeh A, et al. Prevalence of abnormal papanicolaou test results and related factors among women living in Zanjan, Iran. Asian Pacific J Cancer Prevent 2015; 16(16):6935-9.
35. Saha D, Ghosh S, Nath S, et al. Utility of Pap smear screening for prevention of cervical cancer - A 3yrs study from rural Tripura - A northeastern state of India. Int J Med Dent Sci 2017; 6(2):1456-61.
36. Soper D. Reducing the health burden of HPV infection through vaccination. Infect Dis Obs Gyn 2006; 2006:83070.
37. Fakhar HB, Faraji R, Ghane M, et al. Comparison of molecular method and Pap smear in the diagnosis of papillomavirus in women with genital warts. Lab Sci J 2014; 7(3):9-14.
38. Sangrajrang S, Laowahutanont P, Wongsena M. Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani in Thailand. Papillomavirus Res 2017; 3:30-5.
39. Pankaj S, Kumari A, Kumari S, et al. Evaluation of sensitivity and specificity of pap smear, LBC and HPV in screening of cervical cancer. Indian J Gyn Onc 2018; 16(2):49.
2. Arbyn M, Weiderpass E, Bruni L, et al. Estimates of incidence and mortality of cervical cancer in 2018: a worldwide analysis. Lancet Global Health 2020; 8(2):e191-e203.
3. Zhang S, Batur P. Human papillomavirus in 2019: An update on cervical cancer prevention and screening guidelines. Cleveland Clin J Med 2019; 86(3):173-8.
4. GLOBOCAN. New global cancer data|UICC [Internet]. 2020 [cited 2021 Jul 23]. Available from: https://www.uicc.org/news/globocan-2020-new-global-cancer-data
5. Chan CK, Aimagambetova G, Ukybassova T, et al. Human papillomavirus infection and cervical cancer: epidemiology, screening, and vaccination-review of current perspectives. J Oncology 2019; 2019:1-11.
6. Smith RA, Cokkinides V, Brooks D, et al. Cancer screening in the United States, 2011: A review of current American Cancer Society guidelines and issues in cancer screening. Cancer J Clin 2011; 61(1):8-30.
7. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 2015; 136:E359-E386.
8. Co NNC, Tsuneki-Tsukamoto RT, Villa LL, et al. HPV prevalence and detection of rare HPV genotypes in Hong Kong women from southern China with cytological abnormalities. Int Sch Res Notices 2013; 2013:1-7.
9. Bruni L, Albero G, Serrano B, et al. Human papillomavirus and related diseases in Malaysia. Summary Report 2019. ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre). 2019.
10. Wang X, Ji X, Wang M, et al. Prevalence and distribution of human papillomavirus genotypes among women attending gynecology clinics in northern Henan Province of China. Virology J 2022; 19(1):1-7.
11. Derbie A, Mekonnen D, Woldeamanuel Y, et al. Human papillomavirus genotype distribution in Ethiopia: an updated systematic review. Virology J 2022; 19(1):1-8.
12. Ghobadi M, Bashi Zadeh Fakhar H, Shaghaghi B. The prevalence of human papillomavirus genotypes in women with genital warts using polymerase chain reaction (PCR). Int J Cancer Manage 2023; 16(1):e131234.
13. Tabeshian A, Firoozeh F. The effect of health education in performing pap smear for prevention of cervix cancer in teachers of Esfehan city. J Azad Univ Tehran Med Branch 2009; 19(1):35-40.
14. Jemal A, Bray F, Center MM, et al. Global cancer statistics. Cancer J Clin 2011; 61(2):69-90.
15. Sachan P, Singh M, Patel M, et al. A study on cervical cancer screening using pap smear test and clinical correlation. Asia-Pacific J Oncol Nursing 2018; 5(3):338-41.
16. Ghanbari F, Bashi Zadeh Fakhar H, Alamian S, et al. Comparative evaluation of serological, elisa and molecular tests in diagnosis of Brucella abortus in human serum. J Med Bacteriol 2023; 12(1-2):45-52.
17. Jones HW. Nowak's Gynecology. 10th ed. Philadelphia: Lippincott Williams & Wilkins; 1996. p. 453-65.
18. Jaberipour M, Samsami A, Sahraiian F, et al. Elevation of HPV-18 and HPV-16 DNA in the plasma of patients with advanced cervical cancer. Asian Pacific J Cancer Prevent 2011; 12:163-7.
19. Esmaeili M, Bonyadi M, Dastranj A, et al. HPV typing in women with cervical precancerous and cancerous lesions in north-western Iran. Gyn Obs Invest 2008; 66(1):68-72.
20. Wright TC, Schiffman M. Adding a test for human papillomavirus DNA to cervical-cancer screening. New England J Med 2003; 348(6):489-90.
21. Bruni L, Barrionuevo-Rosas L, Albero G, et al. ICO/IARC information centre on HPV and cancer (HPV information centre). Human papillomavirus and related diseases in the world. Summary Report 27 July 2017. 2017.
22. Hajibagheri K, Abaszadeh A, Afrasiabian S, et al. Frequency of human papilloma virus genotypes among women with genital lesions in Sanandaj, Iran. Scientific J Kurdistan Univ Med Sci 2018; 23(3):46-52.
23. Mirbahari SG, Sadegh M. The Prevalence of genus alpha human papillomavirus in women with uterine cervical infection and/or inflammation in Western Iran. Kermanshah Univ Med Sci J 2018; 30(2):113-7.
24. Bidaki MZ, Zardast M, Semnani AN, et al. Investigation of frequency and typing of human papillomavirus among genital warts using a reverse dot blot hybridization approach. BMC Infect Dis 2022; 22:278.
25. Lannér L, Kristina A, Lindström A. Incidence of HPV and HPV related dysplasia in elderly women in Sweden. PLoSOne 2020; 15(3):e0230151.
26. Verma A, Verma S, Vashist S, et al. A study on cervical cancer screening in symptomatic women using Pap smear in a tertiary care hospital in rural area of Himachal Pradesh, India. Middle East Fert Soc J 2017; 22:39-42.
27. Padmini CP, Indira N, Chaitra R, et al. Cytological and colposcopic evaluation of unhealthy cervix. J Evid Based Med Healthcare. 2015; 2(42):6920-7.
28. Gupta SM, Warke H, Chaudhari H, et al. Human papillomavirus E6/E7 oncogene transcripts as biomarkers for the early detection of cervical cancer. J Med Virol 2022; 94(1):1-8.
29. Mijthab N, Saadoon I, Almola E, et al. Relation of HPV genotyping by PCR to cervical Pap smear results in women with genital warts. Med J Tikrit Univ 2018; 24(2):104-12.
30. Brink AA, Snijders PJ, Meijer CJ. HPV detection methods. Dis Markers 2007; 23(4):273-81.
31. Trieu ST, Tran KV, Nguyen TT, et al. Detection and genotyping of the human papillomavirus in Vietnam. Nat Vol Essen Oils 2021; 8(4):11154-63.
32. Saiki Y, Gion Y, Nishikori A, et al. Comparison of the hybrid capture ii method with a pcr-based screening method using a carboxyfluorescein-labeled primer for detecting human papillomavirus in cervicovaginal liquid-based cytology. J Mol Path 2020; 1(1):9-18.
33. Allan BR, Marais DJ, Denny L, et al. The agreement between cervical abnormalities identified by cytology and detection of high-risk types of human papillomavirus. South African Med J 2006; 96(11):1186-90.
34. Maleki A, Ahmadnia E, Avazeh A, et al. Prevalence of abnormal papanicolaou test results and related factors among women living in Zanjan, Iran. Asian Pacific J Cancer Prevent 2015; 16(16):6935-9.
35. Saha D, Ghosh S, Nath S, et al. Utility of Pap smear screening for prevention of cervical cancer - A 3yrs study from rural Tripura - A northeastern state of India. Int J Med Dent Sci 2017; 6(2):1456-61.
36. Soper D. Reducing the health burden of HPV infection through vaccination. Infect Dis Obs Gyn 2006; 2006:83070.
37. Fakhar HB, Faraji R, Ghane M, et al. Comparison of molecular method and Pap smear in the diagnosis of papillomavirus in women with genital warts. Lab Sci J 2014; 7(3):9-14.
38. Sangrajrang S, Laowahutanont P, Wongsena M. Comparative accuracy of Pap smear and HPV screening in Ubon Ratchathani in Thailand. Papillomavirus Res 2017; 3:30-5.
39. Pankaj S, Kumari A, Kumari S, et al. Evaluation of sensitivity and specificity of pap smear, LBC and HPV in screening of cervical cancer. Indian J Gyn Onc 2018; 16(2):49.
| Issue | Vol 13 No 4 (2025) | |
| Section | Original Articles | |
| Keywords | ||
| Genital Warts Human Papillomavirus Pap smear PCR. | ||
| Rights and permissions | |
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This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Rangraz S, Bashi Zadeh Fakhar H, Aslani MH, Shahidi PS. Identification of Human Papillomavirus in Women with Genital Warts by PCR and Pap Smear in Sari. J Med Bacteriol. 2025;13(4):36-44.
