The role of human papillomavirus in gynecological diseases

Papanicolaou (Pap) smears of the cervix and biopsies of the cervix, vagina, vulva, and penis are a substantial portion of the work load of any anatomi c pathology laboratory. The importance of samples from these sites is highl ighted by the fact that their most common disease is dysplasia, which is se xually transmitted and a recognized risk factor for carcinoma. Human papill omavirus (HPV) is an essential co-factor for the development of lower genit al tract dysplasia. Molecular testing for HPV has revealed a great deal abo ut the pathophysiology of dysplasia acid its evolution to carcinoma. Import antly, it now allows diagnostic pathologists the opportunity to be more acc urate in their assessment of common conditions such as Pap smears of squamo us atypia and biopsies equivocal for dysplasia. This review highlights the role of HPV in the evolution of disease in the lower genital tract and stre sses the utility of HPV testing to the diagnostic pathologist.