Human papillomavirus detection in cervical lesions nondiagnostic for cervical intraepithelial neoplasia: correlation with Papanicolaou smear, colposcopy, and occurrence of cervical intraepithelial neoplasia.

Abstract

Human papillomavirus (HPV) is associated with cervical intraepithelial neoplasia (CIN) and carcinomas. The present study involved women who had an abnormal Papanicolaou smear and whose cervix contained acetowhite area(s) that lacked the histologic features of CIN. Sequences homologous to HPV DNA, determined by Southern blot hybridization analysis, were detected in 20 of 59 cervical biopsy specimens (34%) that lacked the histologic features of CIN. When compared with the group in which HPV DNA was not detected, the HPV DNA-positive group had a lower chance of having a normal Papanicolaou smear (30 versus 61%) at the time of the biopsy. There was no difference in the colposcopic findings between the HPV DNA-positive and -negative cases for the biopsy specimens that lacked the features of CIN. However, there was a difference in the rate of histologically proved CIN in the two groups. Twelve of 17 women (71%) in the HPV DNA-positive group for whom there was follow-up information had a biopsy-proved CIN lesion noted at another location in the cervix at the time of biopsy (six) or 3-12 months after the biopsy (six). This rate was significantly higher (P less than .05) than the rate (five of 25, 20%) in the HPV DNA-negative cases, most of whom had no colposcopic abnormalities and a normal Papanicolaou smear at the follow-up examination. These findings indicate that HPV DNA detection in women with cervical lesions that lack the histologic features of CIN predicts current or future CIN in such patients.