Value of morphological criteria in diagnosing cervical HPV lesions confirmed by in situ hybridization and hybrid capture assay

The present study evaluated the value of morphological criteria (binucleati on, multinucleation, koilocytosis, spindle koilocytes, abnormal mitosis and dyskeratosis) in the diagnosis of cervical human papillomavirus (HPV) lesi ons confirmed by in sitit hybridization (ISH) and hybrid capture (HC) assay . Colposcopic punch biopsies from a series of 138 women with abnormal Pap s mears were examined on light microscopy and in situ hybridization (DAKO wid espectrum cocktail probe) for HPV-induced morphological changes and HPV DNA , respectively. Cervical swabs were analyzed for HPV DNA of the oncogenic t ypes using Hybrid Capture. CIN 2 and CIN 3 were found in 44 biopsies, CIN 1 in 62, and no evidence of HPV in 32 cases. HPV was detected by ISH in 51/1 38 (37%) cases and by HC in 66/138 (48%) lesions. With both tests, HPV DNA detection increased parallel with lesion severity, up to 70% and 59% in CIN 2/3 by HC and ISH, respectively OR 4.6 (1.7-12.1) and 10.1 (3.0-33.8). Amo ng the histological criteria, multinucleation, binucleation and abnormal mi toses were significantly associated with HPV DNA detection. Multinucleation proved to be the strongest predictor of HPV DNA-positivity. Binucleation, abnormal mitosis, koilocytosis and spindle koilocytes were also reliable cr iteria of HPV lesions. Minor nuclear atypia, and "mild koilocytosis" were o f no value in making this diagnosis.