Cervical cancer has become widespread these days. If earlier it affected mainly women over 40 years old, now young girls are also affected by it. Pathology ranks third among malignant tumors of the genital organs in women. But it is possible to prevent the development of this disease with the help of modern preventive methods. These include regular determination of the presence of human papillomavirus in the blood - HPV screening (analysis).
Screening is a survey of large groups of the population with the aim of early detection of diseases and timely treatment. Statistics show that HPV screening reduces the chance of cervical cancer by more than 1,000 times!
What is human papillomavirus
Human papillomavirus in its prevalence is on a par with HIV. More than seventy percent of the population is infected with it.
Many infected are carriers of the virus, meaning it does not cause any clinical manifestations. Possible self-healing. But reduced immunitydue to colds, allergic reactions, hyperinsolation cause its activation and the development of diseases.
HPV leads to the appearance of not only papillomas on the skin. There are strains of the virus with high carcinogenicity. Infecting women with them increases the likelihood of cervical cancer.
Therefore, even before the first sexual contact, girls are recommended to conduct an HPV screening, which determines the presence of the virus in the body.
How you can get HPV
The main route of infection is sexual. You can become infected through vaginal, oral and anal sex. Therefore, the presence of human papillomavirus in one partner requires examination of the other.
There is also a contact-household route of infection. This route of infection is possible through contact with the personal belongings of the patient or carrier. Often people become infected when visiting public places: swimming pool, public transport (holding on the handrail), public showers and toilets.
Another way HPV is transmitted is vertical, from mother to child. Placental tissue is permeable to the virus, so it easily enters the fetus through the bloodstream. Also, a child can become infected during natural childbirth during passage through the birth canal.
Types of human papillomavirus
In total, about a hundred types of the virus are isolated, which are divided into groups depending on the degree of carcinogenicity:
- high carcinogenic risk - HPV 16, 18, 31, 33, 35, 39, 45, 58, 59, 68;
- low risk - HPV 6, 11, 42, 43,44;
- not carcinogenic - HPV 1, 2, 3, 4, 5.
Viruses of the first group are also called "highly oncogenic" or HPV HRC. The abbreviation HRC stands for "high carcinogenic risk", that is, the likelihood of developing cancer in such forms is very high. Viruses 16 and 18 are considered the most dangerous.
When these viruses are detected, additional examination methods are prescribed: colposcopy (a detailed examination of the cervix in the mirrors) and a smear for oncocytology (a secret is taken from the cervix and examined under a microscope).
Viruses with a low risk of developing a tumor cause the development of genital warts. These formations are safe and can pass on their own.
Important! The presence of genital warts is a precancerous condition, so if they are detected, you need to be examined by a gynecologist at least once a year.
HPV types that do not promote tumor development lead to warts and papillomas.
Detection methods
What is HPV screening for women? How can you determine the presence of a virus in the blood? There are both methods for establishing the fact of the presence of the virus, as well as tests that allow you to calculate its amount in the body and the degree of its oncogenicity:
- colposcopy - allows you to determine the presence of genital warts or warts;
- cytological method - examining a smear under a microscope and identifying malignant cells;
- histological method - examination of a small area of tissue undermicroscope;
- enzymatic immunoassay - determination of the presence of antibodies of the virus in the blood;
- Digene-test - a modern method with which you can determine the amount of the virus and its oncogenicity;
- polymerase chain reaction (PCR) - detection of virus DNA in body fluids: blood, cervical smear, urine, amniotic fluid, etc.
The first three methods are effective for advanced cervical cancer and are therefore not recommended for screening.
An enzyme-linked immunosorbent assay allows only to establish the fact of the presence of a virus in the body. Digene-test is considered the most effective. Its main disadvantage is the high cost.
The PCR method, which can be both qualitative and quantitative, is the most widespread. And if the first only allows you to establish the fact of the presence of the virus, then with the help of the second you can determine the exact number of the virus in the body. It is quantitative HPV screening that is most effective in preventing cervical cancer. It is recommended every 5 years.
Advantages of polymerase chain reaction
The PCR method allows you to determine the amount of virus in the body, that is, it refers to HPV screening with a viral load. But with its help it is impossible to determine oncogenicity. Therefore, PCR is carried out in order to determine the DNA of the most oncogenic viruses. The doctor, when referring for analysis, indicates the types of virus to look for.
This method has a number of advantages:
- high efficiency - PCR is 100% accurate;
- quick results - viral load is known as early as 4 hours after the test;
- possibility of simultaneous determination of several types of HPV using a single analysis;
- affordable value;
- availability - the ability to make an analysis in almost any medical institution.
PCR screening for HPV HRC. What is it
Examination for papillomavirus with a high degree of oncogenicity is carried out according to a strict scheme. At the first stage, a PAP test is done, which determines the presence of altered cells among the epithelium of the cervix. The presence of such cells is called dysplasia.
If areas of dysplasia are found, the next stage of HPV HRC screening is to determine the amount of the virus in the body, as well as its identification. This stage is also called advanced screening. As a rule, it is carried out using the polymerase chain reaction.
Indications for surrender
HPV screening is done regardless of the presence of symptoms or any disease. But there are a number of pathologies that should alert the doctor and the patient. In the presence of these conditions, the attending physician should immediately refer the patient for HPV testing:
- presence of warts on the genitals, around the anus, around the mouth;
- personal desire of the patient after unprotected intercourse;
- discharge from the genitals, the cause of which is not clear.
Prophylactic testing is also very important. This makes it possible to constantly monitorcondition of the genitals. For carriers, the examination is carried out once a year.
Primary detection of HPV during preventive diagnosis allows for early treatment. This increases the likelihood of a successful recovery in a shorter period of therapy.
How to prepare for analysis
When preparing for it, you must adhere to some rules:
- do not take antivirals and antibiotics at least 3 days before the test, you should also stop antibacterial products for intimate hygiene;
- do not use personal hygiene products on the day of the test;
- do not go to the toilet 2 hours before screening;
- analysis is not given during the menstrual period and within two days after menstruation;
- avoid using contraceptives in the form of gels, ointments or sponges a few days before the test;
- avoid sexual intercourse for at least 2 days before the examination.
If HPV is determined in the blood, the analysis is carried out on an empty stomach, that is, you need to refuse to eat 10-12 hours before the examination. 3 days before screening, you should exclude alcohol intake, adjust the diet: do not eat fried and smoked foods, spices.
Interpretation of PCR results
As a result, the number of virus DNA detected per 100,000 cells is recorded. If the virus is absent, the form indicates that the virus was not detected. If it is in the body, its exact concentration is indicated:
- Lg < 3 - extremelysmall quantity;
- Lg 3-5 - average viral load;
- Lg >5 - virus in high concentration.
There is a risk of a false positive. In such a situation, a laboratory test detects a virus in the blood when it is not actually there.
Where can I find
The main material for detecting the human papillomavirus is the epithelium. In women, it is taken from the cervical canal, in men - from the urethra. In addition to epithelial cells, urine, blood, vaginal and urethral discharges are also used for PCR.
Histological detection of the virus uses a small piece of tissue cut during the examination of the cervix in the mirrors.
How HPV screening is done: sampling rules
To avoid distorting the results, a number of rules are followed when taking material for examination. When taking a smear from the cervical canal, special tools are used - a soft small brush. Previously, the Volkmann metal spoon was widely used, which is now practically not used. The doctor inserts the brush into the cervix and makes several rotational movements. Next, the brush is carefully pulled out and placed in a sterile container to be sent to the laboratory.
What is HPV screening in gynecology? Taking material for histological examination is a more serious procedure. In fact, it is a microscopic surgical intervention.
Therefore, after the histological detection of HPV, physical activity, swimming in the pool are prohibitedor the sea, excessive exposure to the sun. Also, you should not immediately after the examination take blood thinning drugs ("Heparin", "Warfarin"), any medications in the form of vaginal tablets, suppositories, gels, ointments.
What to do after receiving the results
After the patient has received the HPV screening results, they should consult with a specialist. Only the attending physician can correctly interpret and prescribe additional methods of examination and treatment.
All information on the Internet is for guidance only. The final diagnosis can only be made by a qualified specialist!
