Human Papillomavirus Infection and Its Relationship to Cervical Intraepithelial Neoplasia: An immunohistochemical, histopathological and Cytological Study

Kim, Mi Jin; Choi, Won Hee; Lee, Tae Sook

Abstract

It has suggested that a significant proportion of intraepithelial lesion of the cervix may be related to the influence of human papillomaviurs (HPV). Its etiological relation with cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma has recently been proposed. The 131 cases of CIN and 6 condyloma acuminata were stained by immunoperoxidase technique for HPV anigen. The results are as follows: The 18 cases (13.1%) exhibited positive staining, localized in nuclei of koilocytotic cells confined to superficial and intermediate layer of epithelium. HPV antigen was found in 1 case (16.7) of 6 condyloma acuminata, 4 cases (12.5%) of 32 mild dysplasia, 3 cases (13.6%) of 22 moderate dysplasia, 2 cases (14.3%) of 14 severe dysplasia and 8 cases (12.7%) of 63 carcinoma in situ. In the positive cases of mild and moderate dysplasia, HPV antigen was localized directly within the lesion, while those cases of severe dysplaia and carcinoma in situ contained positive cells in areas of mild or moderate dysplasia adjacent to the lesion. Of three distinct morphologic patterns, flat type was most common and papillary type was least. Histologically condylomatous lesions were present in 67 cases (51.1%) out of 131 cases of CIN. The histological and cytological feature encountered most frequently was koilocytotic arypia. Other main histological features are bi- or multinucleation, exocytosis of inflammatory cells, acanthosis, mitotic figures, dyskeratosis and epithelial pearl. On the cervical smear, the evidence of condyloma was proved in 50.0%. Cytologically in the condyloma with high degree of CIN, the nuclear atypia was so prominent that the differentiation from dysplasia or carcinoma in situ was very difficult, although the chromatin appeared somewhat smudged. The mean age of 18 cases was 42.4 years which is older than previous study. The results of this study provide common association with HPV and CIN and add great weight to the suggestion that the infection with HPV plays an important part in genesis of cervical cancer.