CERVICAL KOILOCYTOSIS AND HIGH-RISK HPV TYPES - THE BENEFIT OF LASER VAPORIZATION

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.