Colposcopic correlates of cervical papillomavirus infection

We compared the colposcopic and histologic features of 39 papillomavirus-related cervical lesions with their associated human papillomavirus type. Two thirds of the lesions contained human papillomavirus type 16-related deoxyribonucleic acid, and 69% of them were classified as cervical intraepithelial neoplasia I or II, in contrast to 92% of lesions containing human papillomavirus 6/11 deoxyribonucleic acid. On histologic examination, low-grade cervical intraepithelial neoplastic lesions tended to be sharply demarcated and have an uneven or granular surface contour. In contrast, high-grade lesions often had diffuse borders and were usually smooth in appearance. Both low- and high-grade lesions displayed variable degrees of whiteness, thickness, and papillomatous configurations. Patterns of coarse punctuation were more common in higher grade cervical intraepithelial neoplastic lesions and in those containing human papillomavirus 16. Predictably, the colposcopic features of lesions containing human papillomavirus 6/11 deoxyribonucleic acid sequences compared closely with those of low-grade cervical intraepithelial neoplasia. In contrast, human papillomavirus 16-associated cervical intraepithelial neoplasia exhibited a greater spectrum of colposcopic patterns, including those associated with condyloma and low- and high-grade cervical intraepithelial neoplastic lesions. We conclude that, although a portion of low- and high-grade cervical intraepithelial neoplastic lesions can be distinguished colposcopically, a significant number of lesions containing features of low-grade cervical intraepithelial neoplasia or condyloma contain human papillomavirus 16 deoxyribonucleic acid and cannot be distinguished from presumably innocuous human papillomavirus infections.