Tosi P, Luzi P, Santopietro R, Miracco C, Lio R, Syrjänen S, Mäntyjärvi R, Syrjänen K
Institute of Pathological Anatomy and Histology, University of Siena, Italy.
Appl Pathol. 1988;6(4):247-57.
A series of 69 punch biopsies derived from 513 women prospectively followed up for cervical human papillomavirus (HPV) infections (including HPV lesions with and without cervical intraepithelial neoplasia; HPV-CIN, HPV-NCIN), and 42 control cases (consisting of normal epithelia, and classical CIN lesions) were analyzed morphometrically, using a semiautomatic image analyzer (IBS I-KONTRON), to assess the value of morphometric measurements in discriminating between HPV lesions and CIN, and to find out whether these methods are useful in predicting the outcome of cervical HPV infections. Nuclear area and the form factors Ell, Ar, and Pe were calculated on fifty nuclei in each of the three layers of epithelium; deep, intermediate and superficial. The reproducibility of the measurements was calculated for intra- and interobserver variation. HPV typing was completed using the in situ hybridization technique with DNA probes for HPV 6, 11, 16, 18 and 31. No significant differences were detected by using the form factors (Ell, Ar, Pe), when HPV lesions were compared with the normal epithelium, or with classical CIN lesions, in any of the epithelial layers. The nuclear area was significantly larger in all the epithelial layers in HPV-CIN I, and HPV-CIN II lesions as compared with CIN I and CIN II cases (p less than 0.001), p less than 0.001, p less than 0.005 and p less than 0.001, for deep, intermediate and superficial layers between HPV-CIN I/CIN I, and for all layers in HPV-CIN II/CIN II comparisons, respectively). This was also true when the values of nuclear area in HPV-NCIN I, HPV-CIN II and HPV-CIN III lesions were compared with the normal epithelium (p less than 0.001 for all layers). In the most severe lesions, no significant differences existed between HPV-CIN III and CIN III cases. Nuclear area measurement could not predict, however, the HPV type found in the lesion, or their natural history established by prospective follow-up.
对513名接受宫颈人乳头瘤病毒（HPV）感染前瞻性随访的女性（包括伴有和不伴有宫颈上皮内瘤变的HPV病变；HPV-CIN、HPV-NCIN）获取的69份打孔活检样本，以及42例对照病例（包括正常上皮和典型CIN病变），使用半自动图像分析仪（IBS I-KONTRON）进行形态计量分析，以评估形态计量测量在区分HPV病变和CIN方面的价值，并确定这些方法是否有助于预测宫颈HPV感染的结果。在深层、中层和表层上皮的三层中，每层选取50个细胞核计算核面积以及形态因子Ell、Ar和Pe。计算测量结果在观察者内和观察者间变异的可重复性。使用针对HPV 6、11、16、18和31的DNA探针原位杂交技术完成HPV分型。在任何上皮层中，将HPV病变与正常上皮或典型CIN病变进行比较时，形态因子（Ell、Ar、Pe）均未检测到显著差异。与CIN I和CIN II病例相比，HPV-CIN I和HPV-CIN II病变在所有上皮层中的核面积均显著更大（HPV-CIN I/CIN I的深层、中层和表层之间，p<0.001、p<0.001、p<0.005；HPV-CIN II/CIN II比较的所有层中，p<0.001）。当将HPV-NCIN I、HPV-CIN II和HPV-CIN III病变的核面积值与正常上皮进行比较时也是如此（所有层p<0.001）。在最严重的病变中，HPV-CIN III和CIN III病例之间不存在显著差异。然而，核面积测量无法预测病变中发现的HPV类型或前瞻性随访确定的其自然史。
