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KMID : 0350519940470031255
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Journal of Catholic Medical College
1994 Volume.47 No. 3 p.1255 ~ p.1266
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Utility of Colposcopy and Human Papillomavirus(HPV) Test in the Diagnosis of Uterine Cervical Lesions
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Abstract
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Specific types of HPV are currently implicated as etiologic agents of precursors and cancerous lesions of the uterine cervix. This study used the data gained from one hundred twenty-five women who underwent concurrent Papanicolaou smear,
colposcopic
diagnosis, and cervicovaginal lavage for HPV DNA test at the Dysplasia Clinic in Kangnam St. Mary's Hospital. 38 patients had lowgrade squamous intraepithelial lesion(LGSILs), 34 high-grade squamous intraepithelial lesions (HGSILs), 24 invasive
cervical
cancers, and 29 normal control. Colposcopic features were prospectively recorded by Reid's colposcopic index and then correlated with histopathologic diagnosis. Using the colposcopic index, 86.4% was correlated with histopathologic findings. DNAs
extracted from the cervicovaginal lavages were analyzed by polymerase chain reaction(PCR) using the HPV L1 consensus primer. HPV DNA was detected in 79 of 125 women (63.2%). Prevalence of HPV DNA in the patients with LGSIL(71.1%), HGSIL (76.5%)
and
cervix cancer (75.0%) showed no difference in statistics. Low-risk oncogenic viruses (HPV-6/11) were present in 13.2% of patients with LGSIL, but none was detected in those with HGSIL and cervix cancer. Intermediate-risk oncogenic viruses
(HPV-31/33/35)
were detected in 5.3% of patients with LGCIL, 8.8% in HGSIL and nonein cervix cancer. Prevalence of high-risk oncogenic type HPV-16/18 was higher in HGSIL (41.2%) and invasive cervical cancer (45.8%) than those of LGSIL (15.8%) and control (3.5%)
(P=0.0001).
These data indicate that colposcopic scoring have adjunctive diagnostic role in predicting histology. And, HPV DNAs were found in similar incidence in the various histologic grades of cervical neoplasia. HPV-6/11 was only detected in LGSIL and
HPV-31/33/35 in LGSIL and HGSIL, but not in invasive cancer. HPV-16/18 was the predominant virus which was detected in HGSIL and invasive cervical cancer.
From these results, a combination of HPV typing and colposcopic scoring would provide sensitive screening methods for cervical cancer and precancerous lesion, and HPV typing might have prognostic value in the management of patients with
HPV-related
cervical neoplastic lesions.
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KEYWORD
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