Prediction of 'high-risk' cervical papillomavirus infection by biopsy morphology.
Prediction of 'high-risk' cervical papillomavirus infection by biopsy morphology.
复制标题
通过活检形态学预测“高风险”宫颈乳头瘤病毒感染。
DOI：
10.1093/ajcp/92.5.577
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发表时间：
1989
影响因子：
3.5
通讯作者：
Crum,CP
中科院分区：
文献类型：
--
作者：
Franquemont,DW;Ward,BE;Andersen,WA;Crum,CP
某些人类乳头瘤病毒（HPV）类型（如16型）与高级别癌前病变和宫颈浸润性癌有关。然而，用形态学特征预测HPV感染的存在和类型的准确性是有争议的。三位病理学家使用特定标准对102例连续宫颈活检进行独立分类，并通过原位杂交将其发现与HPV 11、16和18 RNA序列的存在相关联。根据核异型性的存在和分布、有丝分裂异常和嗜空细胞增生，活检分为交界性尖锐湿疣、尖锐湿疣、交界性宫颈上皮内瘤变（CIN）伴嗜空细胞异型性（CINK）和嗜空细胞增生（CIN）。在96%的病例中，有两个或两个以上的观察者对诊断意见一致。在0%的交界性尖锐湿疣、17%的扁平尖锐湿疣、43%的交界性CINK、67%的CINK和77%的CIN病变中检测到HPV 16相关序列。其他hpv，包括那些产生多个探针信号的hpv，分别出现在0%、50%、14%、9%和0%的这些病变中。作者的数据表明，hpv相关宫颈疾病的一致鉴定需要存在特定的细胞学变化。在作者的系列研究中，当存在HPV相关疾病时，CIN是最常见的病变，并且大多数（71%）含有HPV 16相关核酸。因此，高比例（88%）与HPV-16相关的组织学异常可以通过形态学特征单独区分为CIN，并且大多数观察者都可以做出这种区分。
Certain human papillomavirus (HPV) types (such as type 16) have been linked to high-grade precancers and invasive carcinomas of the cervix. However, the accuracy with which morphologic characteristics will predict the presence and type of HPV infection is controversial. Three pathologists independently classified 102 consecutive cervical biopsies with the use of specific criteria and correlated their findings with the presence of HPV 11, 16, and 18 RNA sequences byin situhybridization. Based on the presence and distribution of nuclear atypia, abnormal mitotic figures, and koilocytosis, biopsies were classified into borderline condyloma, condyloma, borderline cervical intraepithelial neoplasia (CIN) with koilocytotic atypia (CINK), and CIN. Two or more observers agreed on the diagnosis in 96% of cases. HPV 16-related sequences alone were detected in 0% of borderline condylomata, 17% of flat condylomata, 43% of borderline CINK, 67% of CINK, and 77% of CIN lesions. Other HPVs, including those producing signals with more than one probe, were present in 0, 50, 14,9, and 0% of these lesions, respectively. The authors data suggest that consistent identification of HPV-related cervical disease requires the presence of specific cytologic changes. In the authors’ series, when HPV-related disease is present, CIN is the most common lesion and most (71%) contain HPV 16-related nucleic acids. Thus, a high proportion (88%) of histologic abnormalities associated with HPV-16 could be distinguished as CIN by morphologic characteristics alone, and this distinction could be made by most observers.