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Published on: March 8, 2012
Prospective serial study of viral change in the cervix and correlation with human papillomavirus genome status
H C Kitchener1, L Neilson, R A Burnett
1Department of Midwifery, University of Glasgow.
Objective:
To observe in serial fashion the histological changes of human papilloma virus (HPV) infection of the cervix and to correlate these with the detection of HPV genomes.
Design:
A prospective longitudinal study to perform colposcopy and at 0, 9 and 18 months to obtain a smear, a biopsy for histology and HPV-16 genome detection by DNA/DNA hybridization.
Setting:
Glasgow Family Planning Centre.
Subjects:
Eighty-two women recruited on the basis of a routine smear showing viral change without dyskaryosis.
Interventions:
Women found to have CIN 3 were treated with laser.
Main Outcome Measures:
Cytology and cervical biopsy results and HPV-16 DNA detection by Southern blotting obtained serially from individual subjects.
Results:
Of 82 women recruited, 10% were positive for HPV-16 detection by Southern blotting. Detection of HPV-16 genomes did not correlate with either CIN or viral infection assessed histologically and serial hybridizations in a given individual showed fluctuation in HPV-16 detection. Polymerase chain reaction in a subset of samples revealed 46% positive for HPV DNA.
Conclusion:
No clear correlation exists between HPV genome detection and the histological appearance. HPV-16 genome detection alone may not be a useful predictor of precancerous progression.
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