NATURAL-HISTORY OF CERVICAL HUMAN PAPILLOMAVIRUS LESIONS

A total of 87 HPV-positive patients with grade I and II cervical intra epithelial neoplasia (CIN I and II) were followed up by cytology and c olposcopy every 3 months for more than 5 years following the first bio psy. These patients were classified into three groups (progressive, pe rsistent, and regressive disease) according to the results. The human papillomavirus (HPV) genome and viral types were identified by Souther n blot hybridization at T-m-40 degrees and T-m-20 degrees with DNA ext racted from exfoliated cervical cells. The lesion progressed to CIN II I in 4/87 patients (4.5%), persisted in 39 patients (44.8%), and regre ssed in 44 patients (50.6%). In the progressive disease group, HPV 16 was detected in 2 patients, HPV 33 in 1 patient, and HPV 52 in 1 patie nt. In the persistent disease group, HPV 58 was predominant (28%), whe reas in the regressive disease group, there was no predominant HPV typ e. In 10/39 patients from the persistent disease group, cytological ex amination transiently revealed severe dysplasia and/or findings simila r to carcinoma in situ. These patients showed severe cytological abnor malities only once or twice during the follow-up. These results sugges t that the natural history of CIN possibly depends upon the type of HP V that infects the cervix, and the relative risk of progression was si milar to that shown by previous cross-sectional studies.