CYTOMORPHOLOGIC EVIDENCE OF HUMAN-PAPILLOMAVIRUS INFECTION IN SMEARS FROM THE IRRADIATED UTERINE CERVIX

OBJECTIVE: To report the cytomorphologic evidence of human papillomavi rus (HPV) infection in cervical smears from women treated with radioth erapy for carcinoma of the uterine cervix. STUDY DESIGN: From January 1986 to December 1993, 32 cervical cytologic smears (CCSs) from women who had received radiotherapy (Rtx) for squamous cell cervical carcino ma at A. C. Camargo Cancer Hospital were selected for study due to the presence of signs of HPV infection. Review of tile files of these pat ients showed 22 additional samples, which we included in this study. T he avidin-biotin-immunoperoxidase technique was performed on previousl y stained slides using polyclonal rabbit antibovine papillomavirus typ e I to confirm the HPV infection. RESULTS: Positive reactions were fou nd in 18 cases (27 samples), mainly in cells with classic koilocytotic features, but also in epithelial cells that lacked cytopathic effects . Only one case, a biopsy from a verrucous lesion observed after Rtx, was found to be positive for HPV 6/11 DNA by in situ hybridization. CO NCLUSION: Cytologic and immunohistochemical positivity for HPV, as wel l as the reaction with a HPV 6/11 DNA probe, strongly suggested that H PV infection was acquired or expressed after radiotherapy. Further stu dies are needed to assess the mechanisms responsible for such an assoc iation.