Ishi K, Shimota H, Kina K, Kawashima T, Utsuno H, Nakamura H
Department of Clinical Laboratory, Juntendo Urayasu Hospital, Juntendo University, School of Medicine, Urayasu.
Rinsho Byori. 1990 Dec;38(12):1353-7.
The usual methods for pathological diagnosis of HPV infection of the uterine cervix include screening in cytodiagnosis and histodiagnosis and confirmation by immunohistochemistry (IHC) method. However, some institutes have recently begun to use in situ hybridization (ISH) method for definitive diagnosis using a DNA probe. We compared IHC with ISH with regards to the localization and rate of detection of HPV in lesions of the uterine cervix such as dysplasia and squamous cell carcinoma in the present study. The cases found positive by IHC showed brownish nuclei of the epithelium and those positive in ISH showed purple to purplish-black nuclei. The comparison of cases positive by both methods revealed that the number of cells positive by IHC was smaller than that by ISH, and the cells positive by IHC were localized in the superficial layer. HPV was detected by the IHC various lesions of the uterine cervix in 13 (12.3%) of 106 patients, while it was detected by the ISH in 39 (36.8%) of 106 patients. The results of both methods were in accordance in 66.0% (77 patients; positively in 8 and negatively in 62). The detection sensitivity of IHC is lower than that of ISH. IHC cannot be used to identify the type of HPV, and it is impossible to confirm the presence or absence of virus by this method in cases of malignant changes. ISH is therefore necessary for identification of HPV and investigation of a histopathological relationship between HPV type and malignant change.
子宫颈HPV感染的病理诊断常用方法包括细胞诊断和组织诊断中的筛查以及通过免疫组织化学（IHC）方法进行确诊。然而，最近一些机构开始使用原位杂交（ISH）方法，利用DNA探针进行明确诊断。在本研究中，我们比较了免疫组织化学（IHC）和原位杂交（ISH）在子宫颈病变（如发育异常和鳞状细胞癌）中HPV的定位和检测率。免疫组织化学检测呈阳性的病例，上皮细胞核呈褐色；原位杂交检测呈阳性的病例，细胞核呈紫色至紫黑色。对两种方法均呈阳性的病例进行比较发现，免疫组织化学检测呈阳性的细胞数量少于原位杂交检测呈阳性的细胞数量，且免疫组织化学检测呈阳性的细胞位于表层。106例患者中，13例（12.3%）子宫颈各种病变通过免疫组织化学检测出HPV，而106例患者中39例（36.8%）通过原位杂交检测出HPV。两种方法的结果在66.0%（77例患者；8例呈阳性，62例呈阴性）的病例中一致。免疫组织化学检测的灵敏度低于原位杂交检测。免疫组织化学不能用于鉴定HPV类型，在恶性病变的病例中无法通过该方法确认病毒的存在与否。因此，原位杂交对于鉴定HPV以及研究HPV类型与恶性病变之间的组织病理学关系是必要的。
