بررسی شیوع ویروس پاپیلومای انسانی در زنان متأهل 60-18 ساله با پاپ اسمیر طبیعی مراجعه‌کننده به کلینیک‌های تخصصی زنان وابسته به دانشگاه علوم پزشکی اصفهان

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیلر، گروه زنان و زایمان، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 استادیار، گروه میکروبیولوژی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

3 دستیار، گروه زنان و زایمان، دانشکده‌ی پزشکی و کمیته‌ی تحقیقات دانشجویی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: سرطان دهانه‌ی رحم دومین علت مرگ و میر در اثر سرطان در بین زنان می‌باشد. تیپ‌های پر خطر ویروس پاپیلومای انسانی ( HPV یا papillomavirus Human) عامل اصلی سرطان سرویکس هستند. این مطالعه با هدف تعیین شیوع تیپ‌های 6، 11، 16 و 18 HPV در زنان متأهل 60-18 ساله با پاپ اسمیر طبیعی انجام شد. روش‌ها: در این مطالعه‌ی توصیفی-تحلیلی 180 نفر از زنان متاهل 60-18 ساله که در سال‌های 1389-1388 به کلینیک‌های تخصصی زنان وابسته به دانشگاه علوم پزشکی اصفهان مراجعه کرده بودند، به روش در دسترس بررسی شدند. پس از بررسی سیتولوژی در پاپ اسمیر از کلیه‌ی نمونه‌های طبیعی یک نمونه تهیه گردید. سپس با انجام PCR ابتدا ویروس HPV با استفاده از پرایمرهای GP5+ و GP6+ شناسایی شد. نمونه‌های حاوی HPV برای تعیین ژنوتیپ با استفاده از پرایمرهای اختصاصی برای تیپ‌های 6، 11، 16 و 18 PCR مجدد شدند.یافته‌ها: بر اساس مرحله‌ی اول PCR (Polymerase chain reaction) از بین 180 نمونه ویروس HPV در 46 نمونه (55/25 درصد) یافت شد. از 46 نمونه‌ی مثبت 7 نمونه (21/15درصد) تیپ 16، 6 نمونه (04/13 درصد) تیپ 18، 10 نمونه (74/21 درصد) تیپ‌های 11 یا 6 و 23 نمونه (50 درصد) از سایر تیپ‌های این ویروس بود. در میان 180 نمونه‌ی مورد مطالعه در 13 نمونه (22/7 درصد) حداقل یکی از تیپ‌های پر خطر 18 و 16 یافت شد.نتیجه‌گیری: با توجه به شیوع بالای این ویروس در مطالعه‌ی ما و سایر مطالعات انجام شده در منطقه، انجام اقدامات پیشگیری از بروز این مشکل ضروری به نظر می‌رسد. یکی از روش‌های پیشگیری استفاده از واکسن گارداسیل است که تأثیر مناسب آن در مطالعات نشان داده شده است.

کلیدواژه‌ها

عنوان مقاله [English]

Reviewing the Prevalence of Human Papillomavirus (HPV) in Married Women Aged 18-60 Years with Normal Pap Smear and Referring to Gynecology Clinics in Hospitals Affiliated to Isfahan University of Medical Sciences, Iran

نویسندگان [English]

  • Tajossadat Allameh 1
  • Sharareh Moghim 2
  • Farinaz Farahbod 3
1 Associate Professor, Department of Obstetrics and Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Assistant Professor, Department of Microbiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
3 Resident, Department of Obstetrics and Gynecology, School of Medicine And Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: Cervical cancer is the second leading cause of mortality due to cancer among women. Since 1970, Human papillomavirus (HPV) has been proposed as the main etiologic factor for cervical cancer. High-Risk HPV types have been the major cause of cervical cancer. Therefore, it seems necessary that the most common HPV types in each population should be determined separately so that they can be used for an effective screening program, disease management, and the vaccination of the target population. To do so, the prevalence of type 6, 11, 16 and 18 of HPV were studied in married women aged 18-60 years, with normal Pap smear, referring to gynecology clinics in hospitals affiliated to Isfahan University of Medical Sciences, Iran, during 2009-2010 using the PCR technique.Methods: In this descriptive-analytical study, 180 married women aged 18-60 years with normal Pap smear, who referred to gynecology clinics in hospitals affiliated to Isfahan University of Medical Sciences, Iran, were selected through available sampling method. After cytological screening in Pap smear, a specimen was collected from all the normal samples using Cervex-Brush® Combi. DNA samples were extracted using phenol chloroform, and the extracted DNA samples were confirmed using PCO3 primers and PCO from Beta Globin gene. In the first stage of PCR, HPV was identified through primers GP5+ and GP6+, and the samples containing HPV underwent PCR again in order to determine their genotype using specific primers for types 6, 11, 16, and 18.Findings: In the first stage of PCR among 180 studied specimens, HPV was found in 46 specimens (25.55%). Out of 46 positive specimens, 7 specimens (15.21%) belonged to type 16, 6 specimens belonged to type 10 (13.04%), 18 specimens belonged to types 11 or 6 (21.74%), and 23 specimens (50%) belonged to other types of this virus. Among 180 studied samples, at least one of the high-risk types was found in 13 specimens (7.22%).Conclusion: Given to the high prevalence of this virus in the present study and other conducted studies, particularly types 16 and 18 which have been proved to be risk factors for premalignant and malignant cervical lesions, and also the good effect of Gardasil vaccine, using this vaccine can be an important step towards preventing cervical cancer in the studied women. 

کلیدواژه‌ها [English]

  • Normal Pap smear
  • Human papillomavirus
  • PCR
  • Cervical cancer

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مجله دانشکده پزشکی اصفهان
دوره 29، شماره 163 - شماره پیاپی 163
آذر و دی 1390
صفحه 2048-2054

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سابقه مقاله

  • تاریخ دریافت: 30 خرداد 1390
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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