Nuovo G J, Blanco J S, Silverstein S J, Crum C P
Department of Microbiology, Columbia University, New York, New York.
Obstet Gynecol. 1988 Nov;72(5):770-4.
Vaginal warts (condylomata) secondary to human papillomavirus (HPV) infection are most easily identified when perinuclear halos are seen with clear-cut nuclear atypia (koilocytotic atypia) in the superficial cells of the lesion. However, vaginal lesions clinically resembling condylomata may exhibit lesser degrees of nuclear atypia with findings suggestive of, but not typical for, the presence of HPV. The diagnosis and management of such lesions are unclear. We correlated histologic findings with the detection of HPV DNA sequences in 39 vaginal lesions that contained a spectrum of clinical and histologic features suggestive of, or diagnostic for, condyloma. We detected HPV DNA in 63% (N = 22) of lesions with koilocytotic atypia and in 11.7% (N = 17) of lesions that showed some histologic features suggesting condyloma but that lacked koilocytotic atypia. These findings imply that vaginal lesions lacking koilocytotic atypia are not always caused by HPV, emphasizing the need for a conservative approach when the diagnosis of vaginal condyloma is not clear-cut.
人乳头瘤病毒（HPV）感染继发的阴道疣（尖锐湿疣），当在病变浅表细胞中见到核周晕并伴有明确的核异型性（挖空细胞异型性）时最易识别。然而，临床上类似尖锐湿疣的阴道病变可能仅表现出较轻程度的核异型性，其表现提示但并非典型的HPV感染。此类病变的诊断和处理尚不明确。我们将组织学结果与39例阴道病变中HPV DNA序列的检测结果进行了关联分析，这些病变具有一系列提示或诊断为尖锐湿疣的临床和组织学特征。在具有挖空细胞异型性的病变中，63%（N = 22）检测到HPV DNA；在显示一些提示尖锐湿疣但缺乏挖空细胞异型性的组织学特征的病变中，11.7%（N = 17）检测到HPV DNA。这些发现表明，缺乏挖空细胞异型性的阴道病变并非总是由HPV引起，强调在阴道尖锐湿疣诊断不明确时需要采取保守方法。
