CYTOLOGICAL DIAGNOSTICS OF SCREENING WITH HPV TESTING AS AN EARLY MARKER OF CERVICAL CANCER

Gulnara Sakhipova, Saule Akhmetova, Kanguzhieva K.K., State municipal enterprise "Regional pathological anatomical bureau", Aynagul Khairullina

2025

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DOI 10.53511/pharmkaz.2025.2.3
Data confidence 70 medium
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Abstract

WHO has put forward a three-pronged approach to eliminate the social problem: 90% coverage of HPV vaccination among girls by the age of 15, 70% of women from the age of 35 coverage of screening using a highly effective test and treatment of cervical cancer at an early stage, and adequate treatment of cervical cancer in 90% of women. Expectation: preventing 74 million new cases of cervical cancer and 62 million deaths in 78 low- and middle-income countries in the coming decades The purpose of the study: clinical validation of HPV testing with cytology for early detection of cervical cancer. Methods and materials: The examination was carried out according to a generally accepted protocol: clinical examination, preparation of cytological smears using liquid leukocytology, evaluation of smears using the Bethesda system, detection and genotyping of high-risk HPV DNA on a Cobas 4800 device, which is a fully automated system, and extended colposcopy.Study design: prospective-cohort. Results: The number of women screened tended to increase: in 2021 - 27,163 women; in 2022 - 29,205 women; in 2023 - 27,396 women; in 2024 for 9 months - 25,819 women. A total of 109,583 women were examined, of which 4,359 women had pathological changes. The age range of the women studied: 30 years - 70 years, the average age is 50 ± 8.2 years. The results of cytological screening by liquid cytology for the period from 2021 to 2024 showed that among 4359 women, atypical cells of multilayer squamous epithelium of unclear value were detected in 144 (3.3%), mild dysplasia in 252 (5.7%), severe dysplasia in 167 women (3.8%), suspected cancer in 40 cases (0.9%) cancer in 8 cases (0.2%). HPV 16 was detected in invasive cancer in 72.8% and in CIN 3 in 65.5%, VPCh-31 in 11%, HPV 33-in 11.3%, HPV 52 in 11.6%, HPV 58 in 12%, when VPCh-18 was detected much less often, in 5.2%. Novelty of the study: the sensitivity of the PCR method for detecting HPV of high oncogenic risk (65.5-72.8%) exceeds the sensitivity of the cytological study (42-50%). Practical application of the study: HPV testing, as a marker of dysplasia and carcinoma, can play a leading role not only in triaging patients with low-grade cytological abnormalities of the cervix, but also increase oncongreatedness for cervical cancer depending on the patient's age.