Recent Progress in Defining the Epidemiology of Human Papillomavirus Infection and Cervical Neoplasia

Human papillomavirus status in the prediction of high-grade cervical intraepithelial neoplasia in patients with persistent low-grade cervical cytological abnormalities

“…These data demonstrate that the presence of CIN 2 or 3 in patients with mild cytological abnormalities can be predicted by molecular detection of HPV in some cases, particularly when combined with cytological analysis. However, the magnitude of this prediction is dependent on the population of patients studied, and the clinical role of this approach therefore remains to be defined.Keywords: human papillomavirus; cervix, neoplasia; cytology Human papillomaviruses are present in a wide variety of intraepithelial lesions of squamous epithelium (de Villiers, 1989;Chang, 1990;Munoz et al, 1992;Schiffman. 1992), including those of the cervix uteri.…”

“…1992), including those of the cervix uteri. The presence of certain HPV types (16, 18, 31, 33, 35 and others) is associated with high-grade lesions namely CIN 2 and 3 and invasive cervical carcinoma but these types are found less frequently in lowgrade lesions (CIN 1 and wart virus change only) and in patients with negative cervical biopsies (Munoz et al, 1992;Schiffman, 1992;Lorincz et al, 1993;Schiffman et al, 1993).This association suggests that the detection of these viral types in an individual patient might be predictive of the presence of a high-grade lesion or a high-risk of progression of a low-grade lesion. The morphology of signal produced by in situ hybridisation correlates with the presence of viral integration (Cooper et al, 1991a;Kristiansen et al, 1994), and in studies of CIN and invasive carcinoma this punctate pattern was found in all HPV-positive cervical carcinomas and 69% of HPV-positive CIN 3 lesions (Cooper et al, 1991 b,c).…”

“…The morphology of signal produced by in situ hybridisation correlates with the presence of viral integration (Cooper et al, 1991a;Kristiansen et al, 1994), and in studies of CIN and invasive carcinoma this punctate pattern was found in all HPV-positive cervical carcinomas and 69% of HPV-positive CIN 3 lesions (Cooper et al, 1991 b,c). Moreover, it has been suggested that it is not merely the presence of high-risk HPV types but the amount of viral DNA which is predictive of a high-grade lesion (Cuzick et al, 1992), although the strength of this prediction varies between studies (Cuzick et al, 1992Herrington et al, 1992a;Bavin et al, 1993).The recommended management of patients with moderately and severely dyskaryotic cells present in a cervical smear is immediate referral for colposcopy and possible treatment (National Coordinating Network, 1992 …”

“…Keywords: human papillomavirus; cervix, neoplasia; cytology Human papillomaviruses are present in a wide variety of intraepithelial lesions of squamous epithelium (de Villiers, 1989;Chang, 1990;Munoz et al, 1992;Schiffman. 1992), including those of the cervix uteri.…”

Evaluation of the significance of polyamines and their oxidases in the aetiology of human cervical carcinoma

“…However, simple models based upon infectious agents alone, such as human papillomavirus (HPV), have been shown to be inadequate. HPV infection is still much more common than the occurrence of cervical intraepithelial neoplasia (CIN) and invasive cervical cancer (Schiffman, 1992); most women who are HPV positive show no evidence of cervical abnormalities (De Villiers et al, 1987;Meanwell et al, 1987; Reeves et al, 1987) and only a small proportion of women with HPV develop cervical cancer (Mitchell et al, 1986). Furthermore, the long latent penrods (20-50 years) between HPV infection and the development of cancer (zur Hausen, 1986) suggests that HPV alone is insufficient to induce cervical cancer.…”