SUMMARY Histological and immunocytochemical features of cervical intraepithelial neoplasia (CIN) associated with HPV 6 and HPV 16, either singly or in combination, were studied in 48 cases. Features of HPV infection (koilocytosis, binucleation, multinucleation, giant irregular nuclei and individual cell dyskeratosis) were present in high prevalence in both HPV 6 and HPV 16 associated CIN. Abnormal mitoses seemed to be a good indicator of.CIN and were present in about 50% of cases of CIN associated with either HPV 6 or HPV 16 infection. This finding provides no support for the view held by some investigators that associated HPV 16 infection can be predicted by the presence of abnormal mitoses. Expression of HPV antigen was shown in about 40% of cases with a slight, but not significantly, higher prevalence in cases of combined HPV 6 and HPV 16 infection. Conventional histology and immunocytochemistry could not distinguish CIN associated with HPV 6 from CIN associated with HPV 16 infection.Human papillomavirus (HPV), in particular HPV types 6, 11, 16, and 18, have been associated with the aetiology of cervical neoplasia.`3 HPV types 6 and 16 account for most HPV infection in the female lower genital tract in Great Britain,4 and they seem to have different tumorigenic potential. HPV type 6 is found most commonly in cervical condylomata acuminata and cervical intraepithelial neoplasia (CIN) of lower grades while HPV type 16 is associated with CIN of more severe grades1 S and invasive cancer.6Knowledge of the type of HPV associated with CIN in an individual patient might be of prognostic importance.To date, it has not been possible to grow HPV in culture. Typing is performed with the DNA-DNA hybridisation technique, which demands extensive technical experience and expertise. It would be advantageous if histological features could be identified to distinguish CIN associated with HPV type 6 from type 16 infection. Gross7 reported HPV type specific cytopathic effects recognisable on routine histology for HPV types 3, 4, and 6, and, in a small study Accepted for publication 29 May 1986 Crum8 suggested that the presence of HPV type 16 in cervical flat warts may be predicted by the presence of abnormal mitoses.The purpose of this study was to investigate if HPV type 6 and type 16 produce different and discriminatory cytopathic effects in CIN recognisable by conventional histology and to investigate the prevalence and pattern of the expression of HPV viral antigen in both types of infection.
Material and methods
STUDY GROUPPatients were drawn from a cohort of women attending a district colposcopy clinic who participated in a recent study of the prevalence of different types of HPV in the uterine cervix.5 Because of the lower prevalence of HPV type 6 in CIN, all the patients with HPV 6 DNA in their lesions were included in the study. Thirty patients were randomly selected from the group with HPV 16 DNA and another 10 patients with no HPV DNA sequences were also studied. In the study on HPV antigen expression a larger group...
SUMMARY Twenty eight biopsy specimens of the cervix showed positive immunohistochemical staining when treated with an antiserum raised against an internal capsid antigen of human papillomavirus (HPV). Histological examination of adjoining sections from the same blocks showed a much wider range of abnormalities than those already described in association with HPV infection. The picture was usually diagnostic. It rested chiefly on identifying the koilocyte-the cell with the perinuclear halo that carries the viral antigen in its nucleus-but abnormal keratinisation was also a feature. The accompanying epithelial findings ranged from normal to CIN III (cervical intraepithelial neoplasia). The latter was of an unusual but distinct appearance, in which cytoplasmic maturation was preserved to some degree but in which gross nuclear atypia was seen in all layers of the epithelium.
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