Murdoch J B, Cassidy L J, Fletcher K, Cordiner J W, Macnab J C
Medical Research Council Institute of Virology, University of Glasgow.
Br Med J (Clin Res Ed). 1988 Feb 6;296(6619):381-5. doi: 10.1136/bmj.296.6619.381.
Biopsy samples from 27 patients referred to a colposcopy clinic in Glasgow for cervical abnormalities were assessed for the relations among colposcopic appearances, cytological and histological diagnosis, expression of papillomavirus antigen, and the presence of human papillomavirus (HPV) types 6, 11, 16, and 18 deoxyribonucleic acid (DNA) sequences. Specimens were from colposcopically abnormal areas of the transformation zone and from colposcopically apparently normal areas of the zone in the same patients (paired matched internal control tissue). All 27 women referred for abnormal smears had colposcopic abnormalities. HPV-16 or 18 DNA sequences were detected in 20 of the 27 colposcopically abnormal biopsy samples and 13 of the 27 paired normal samples. Twelve samples of colposcopically normal tissue contained histological evidence of viral infection but only four of these contained HPV DNA sequences. The other nine samples of colposcopically normal tissue which contained HPV DNA sequences were, however, histologically apparently normal. HPV-6 and 11 were not detected. Integration of the HPV-16 genome into the host chromosome was indicated in both cervical intraepithelial neoplasia and control tissues. In two thirds of the HPV DNA positive samples the histological grade was classed as normal, viral atypia, or cervical intraepithelial neoplasia grade 1. Papillomavirus antigen was detected in only six of the abnormal and three of the normal biopsy samples, and HPV DNA was detected in all of these. The detection of HPV DNA correlates well with a combination of histological and cytological evidence of viral infection (20 of 22 cases in this series). A poor correlation between the site on the cervix of histologically confirmed colposcopic abnormality and the presence of HPV DNA sequences implies that a cofactor other than HPV is required for preneoplastic disease to develop. A separate study in two further sets of biopsy samples examined the state of HPV DNA alone. The sets were (a) 43 samples from cervical intraepithelial neoplasia and nine external controls and (b) 155 samples from cervical intraepithelial neoplasia, cervical cancer, vulval intraepithelial neoplasia, and vulval cancer and external controls. HPV-11 was found in only two (4.7%) of the 43 specimens from cervical intraepithelial neoplasia, whereas HPV-16 was found in 90 (58%) of the other 155 specimens. These results also suggest that HPV subtype is subject to geographical location rather than being an indicator of severity of the lesion or of prognosis.
对27名因宫颈异常转诊至格拉斯哥一家阴道镜诊所的患者的活检样本进行了评估，以研究阴道镜表现、细胞学和组织学诊断、乳头瘤病毒抗原表达以及人乳头瘤病毒（HPV）6、11、16和18型脱氧核糖核酸（DNA）序列之间的关系。样本取自同一患者转化区的阴道镜异常区域以及该区域阴道镜下看似正常的区域（配对的内部对照组织）。所有27名因涂片异常而转诊的女性均有阴道镜异常。在27份阴道镜异常的活检样本中的20份以及27份配对的正常样本中的13份中检测到了HPV - 16或18 DNA序列。12份阴道镜正常组织样本含有病毒感染的组织学证据，但其中只有4份含有HPV DNA序列。然而，另外9份含有HPV DNA序列的阴道镜正常组织样本在组织学上看似正常。未检测到HPV - 6和11。在宫颈上皮内瘤变组织和对照组织中均显示HPV - 16基因组整合到宿主染色体中。在三分之二的HPV DNA阳性样本中，组织学分级为正常、病毒异型或宫颈上皮内瘤变1级。仅在6份异常活检样本和3份正常活检样本中检测到乳头瘤病毒抗原，并且在所有这些样本中均检测到了HPV DNA。HPV DNA的检测与病毒感染的组织学和细胞学证据相结合的情况相关性良好（本系列22例中的20例）。组织学确诊的阴道镜异常部位与HPV DNA序列的存在之间相关性较差，这意味着癌前疾病的发生需要HPV以外的其他辅助因素。在另外两组活检样本中进行的一项单独研究仅检查了HPV DNA的状态。这两组样本分别为：（a）43份来自宫颈上皮内瘤变的样本和9份外部对照样本；（b）1份来自宫颈上皮内瘤变、宫颈癌、外阴上皮内瘤变和外阴癌的样本以及外部对照样本。在43份来自宫颈上皮内瘤变的样本中仅在2份（4.7%）中发现了HPV - 11，而在另外155份样本中的90份（58%）中发现了HPV - 16。这些结果还表明，HPV亚型受地理位置影响，而非病变严重程度或预后指标。
