IN-SITU HYBRIDIZATION FOR THE DETECTION O F HUMAN-PAPILLOMAVIRUS - CLINICAL, PATHOLOGICAL AND VIROLOGICAL CORRELATIONS IN PATIENTS WITH SQUAMOUS INTRAEPITHELIAL LESIONS OF THE UTERINE CERVIX

BACKGROUND: Clinical usefulness of human papillomavirus (HPV) detectio n by molecular techniques is not well established. The aim of the stud y is to determine, by in situ hybridization, HPV DNA in patients with cervical intraepithelial neoplasia (GIN), assessing the prevalence rat e, the association with epidemiologic factors and the correlation with classic diagnostic procedures (cytology, celposcopy and histology). P ATIENTS AND METHODS: Among 138 patients diagnosed with GIN, HPV was de termined in 75 treated by excisional procedures. All cases underwent p ap-smear, colposcopy, and colposcopically directed biopsy, RESULTS: Hi stologic diagnosis was as follows: 1 cervical condyloma (1.3%); 31 GIN -I (41.3%); 23 GIN II (30.7%), and 20 GIN-III (26.7%). HPV was detecte d in 31 cases (41.3%), being more frequent in higher histologic grades (35.5% CIN I, 43.5% GIN-II and 45% GIN-III). No association between c ytologic, colposcopic and histologic diagnoses and HPV positivity was observed, HPV detection in patients with false negative cytologies was lower than in positive ones (p = 0.021). Smoking was the only epidemi ologic factor significantly associated to HPV presence (chi(2) for tre nd = 4.022; p = 0.045). CONCLUSIONS: Clinical usefulness of in site hy bridization for HPV detection remains controversial because of its low sensitivity, and the scarce relationship between its results and thos e obtained by cytology, colposcopy and histology. Smoking is associate d with a higher detection rate of HPV in patients with squamous intrae pithelial lesions of the uterine cervix.