U. Hording et al., CERVICAL KOILOCYTOSIS AND HIGH-RISK HPV TYPES - THE BENEFIT OF LASER VAPORIZATION, European journal of obstetrics, gynecology, and reproductive biology, 51(2), 1993, pp. 125-130
Forty-six patients with biopsy-proven cervical koilocytosis, which in
19 cases was associated with CIN I, were randomized to treatment by ce
rvical laser vaporization or to follow-up without therapy. The polymer
ase chain reaction was used to examine the paraffin-embedded cervical
biopsies for human papillomavirus (HPV) types 6, 11, 16, 18 and 33 by
polymerase chain reaction and molecular hybridization technique. Twent
y biopsies contained HPV DNA, in 17 cases of the putatively oncogenic
types HPV 16 and HPV 18. During a mean follow-up of 28 months, the les
ions resolved in 37 women, 5 women had progression to CIN III lesions,
and 4 women had persisting disease. Lesions not harboring any of the
5 HPV types showed a high spontaneous regression rate of 88%, which wa
s not improved by the laser therapy. In the HPV-positive lesions, reso
lution occurred in only 29% of untreated lesions, but in 92% of those
treated by laser. The difference is significant (P = 0.007). It is con
cluded that in patients with cervical koilocytosis, the HPV diagnosis
could be of practical value in identifying patients who might benefit
from treatment.