The prevalence of human papillomavirus antigen in patients with cervical intraepithelial neoplasia.
The prevalence of human papillomavirus antigen in patients with cervical intraepithelial neoplasia.
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宫颈上皮内瘤变患者人乳头瘤病毒抗原的流行情况。
DOI：
10.1038/bjc.1983.163
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发表时间：
1983
影响因子：
8.8
通讯作者：
Coleman,DV
中科院分区：
文献类型：
--
作者：
Walker,PG;Singer,A;Dyson,JL;Shah,KV;To,A;Coleman,DV
直到最近，人乳头瘤病毒（HPV）感染子宫颈被认为是罕见的。Marsh在世界文献中仅发现10例宫颈尖锐湿疣（Marsh，1952）。Raftery和Payne（1954）在1949-1954年的5年中，在他们实验室观察的587例宫颈活检中，3%发现尖锐湿疣的组织学证据。最近的细胞学和阴道镜研究（Meisels和Fortin，1976; Meisels等人，1977; Reid等人，1980年）表明，这种感染比早期报告所指出的更常见。在最近的研究中，患病率的增加被解释为以前未被认识到的“扁平疣”宫颈病变，在阴道镜放大倍数增加时可见。对这些扁平病变的患病率的初步研究依赖于用于其诊断的主观细胞学和组织学标准（Meisels等人，1977; Reid等人，1982年）。我们通过一种鉴定乳头瘤病毒抗原的客观免疫组化技术，调查了宫颈涂片异常的妇女中疣病毒感染的患病率。材料阴道镜指导宫颈活检139名妇女参加区阴道镜诊所进行了研究。这些患者的细胞学报告为：轻度核异常（通常复发）51例，中度核异常38例，重度核异常50例。将活检组织固定在升华甲醛中，包埋在石蜡中并分为3个水平;切片用于免疫组织化学研究。使用间接免疫碱性磷酸酶技术证明乳头瘤病毒抗原（To等人，1983）和通过用来自纯化自足底疣池的病毒体的破坏衣壳免疫兔制备的抗血清。抗血清的特异性已经使用电子显微镜证实，以证实阳性染色细胞中的病毒颗粒（Jenson等人，1980年）。切片中乳头瘤病毒抗原的存在在光学显微镜下可检测为鳞状上皮细胞核中的深红色。当仅用底物处理或当省略初级抗血清并用正常山羊血清代替时，对照切片为阴性。组织学和免疫组织化学研究结果见表I。在25例组织学无异常的切片中，病毒抗原检出率为8%，在14例单独诊断为疣病毒感染的病例中，病毒抗原检出率为57%。98例宫颈上皮内瘤样病变（CIN）患者中18.3%的活检组织病毒抗原阳性，但两例浸润性癌均未显示阳性染色。
Until recently, infection of the uterine cervix by human papillomavirus (HPV) was thought to be rare. Marsh could find only 10 reported cases of condyloma acuminatum of thecervix in the world literature (Marsh, 1952). Raftery and Payne (1954) found histological evidence of condyloma acuminatum in 3% of 587 biopsies from the uterine cervix seen in their laboratory in the 5 years from 1949-1954. Recent cytological and colposcopic studies (Meisels & Fortin, 1976; Meisels et al., 1977; Reid et al., 1980) have suggested that this infection is more common than early reports indicated. The increase in prevalence in more recent studies is explained by a previously unrecognised" flat wart" cervical lesion, visible with the increased magnification of colposcopy. Initial investigations of the prevalence of these flat lesions have depended on subjective cytological and histological criteria for their diagnosis (Meisels et al., 1977; Reid et al., 1982). We investigated the prevalence of wart virus infection of the cervix in women presenting with abnormal smear reports by an objective immunohistochemical technique for identifying papillomavirus antigen. Material from colposcopically directed cervical biopsies from 139 women attending a district colposcopy clinic were studied. The presenting cytology reports for these patients were: mild dyskaryosis (usually recurrent in 51, moderate dyskaryosis in 38 and severe dyskaryosis in 50. The biopsies were fixed in formol sublimate, embedded in paraffin and divided at 3 levels; sections were taken for immunohistochemical studies. Papillomavirus antigen was demonstrated using an indirect immunoalkaline phosphatase technique (To et al., 1983) and an antiserum prepared by the immunization of a rabbit with disrupted capsids from virions purified from a pool of plantar warts. The specificity of the antiserum has been demonstrated using electron microscopy to demonstrate virus particles in positively staining cells (Jenson et al., 1980). The presence of papillomavirus antigen in the sections was detectable in the light microscope as a deep red colouration in the nuclei of squamous epithelial cells. Control sections were negative when treated with substrate alone or when the primary antiserum was omitted and substituted by normal goat serum The results of the histological and immunohistochemical investigations are shown in Table I. Viral antigen was found in 8% of 25 sections where no histological abnormality was present and in 57% of 14 cases diagnosed as wart virus infection alone. Biopsies from 18.3% of98 patients with cervical intraepithelial neoplasia (CIN) were positive for viral antigen but neither of the two cases of invasive cancer displayed positive staining.