Human papillomavirus (HPV) in high-grade cervical intraepithelial neoplasia (CIN) detected by morphology and polymerase chain reaction (PCR) - a cytohistologic correlation of 277 cases treated by laser conization

The aims of this study were to evaluate the cytohistologic correlation in w omen treated for high-grade lesions of the cervix uteri (HG GIN), to assess the distribution of HPV features and finally to test the validity of the m orphological criteria of HPV infection. The smears and biopsy specimens fro m 277 women treated for HG CIN by laser conization were re-evaluated blindl y. Tissue blocks (n = 188) and 52 archival smears were examined for HPV DNA using PCR. HPV changes were detected with equal frequency in the smears an d biopsy specimens by light microscopy; 63% and 65%, respectively. The prev alence of HPV DNA in biopsies was 88% and in archival smears 85%; agreement was found in 89% of the cases. Using PCR as the Sold standard, we found a sensitivity of 63% for cytology and 70% for histology; the specificity was 41% and 37%, respectively. The positive predictive value was > 80%, but the negative predictive value was < 20%. Our study confirms that HPV features are frequently associated with I-IG CIN and that morphology is a non-specif ic method of identifying HPV infection and should be followed by PCR, also allowing detection of oncogenic HPV types and latent infections.