Winkler B, Crum C P, Fujii T, Ferenczy A, Boon M, Braun L, Lancaster W D, Richart R M
Cancer. 1984 Mar 1;53(5):1081-7. doi: 10.1002/1097-0142(19840301)53:5<1081::aid-cncr2820530511>3.0.co;2-l.
It has been reported that abnormal mitotic figures (AMFs) occur principally in aneuploid lesions and that aneuploidy is a diagnostic feature of non-endocrine-dependent epithelial cancer precursors and cancers. Recently, AMFs have been reported in cervical lesions interpreted as flat condylomata, and it has been suggested by several authors that AMFs may not be diagnostic or aneuploidy or neoplasia, particularly in human papillomavirus-(HPV)-induced lesions. Although it is conceivable that AMFs may be a regular feature of HPV infection, their association with cytologic atypia and their presence in higher grades of cervical intraepithelial neoplasia (CIN) suggests that AMFs may herald the presence of a different lesion than the pure flat condyloma. In the current study, koilocytotic cervical lesions thought to be HPV-induced were examined microscopically for the presence of AMFs, and the findings were correlated with the presence of HPV as determined by immunoperoxidase and nuclear DNA distribution patterns as measured by Feulgen microspectrophotometry. In unselected lesions originally diagnosed as flat cervical condylomata, AMFs were surprisingly common (22.6%), and did not correlate with the extent of koilocytosis. Immunoperoxidase (IMPO) stains were performed in 35 cases with AMFs, and were negative for HPV in 74.3% and positive in 22.8%. However, among the cases evaluated by IMPO, there was an inverse relationship between the presence of mitotic abnormalities and the expression of HPV antigen. Nine of 11 (81.8%) lesions containing AMFs were aneuploid, and 2 of 11 (18.2%) were polyploid. Abnormal mitotic figures have a range of morphology and frequency in koilocytotic cervical lesions. Although the biology of these lesions is not well-defined, the presence of AMFs may identify a subgroup of HPV-induced cervical atypias which represent a transition between flat cervical conylomata and CIN.
据报道，异常有丝分裂象（AMFs）主要出现在非整倍体病变中，并且非整倍体是非内分泌依赖性上皮癌前病变和癌症的诊断特征。最近，在被解释为扁平湿疣的宫颈病变中也发现了AMFs，几位作者认为AMFs可能并非非整倍体、肿瘤形成的诊断依据，尤其是在人乳头瘤病毒（HPV）诱导的病变中。虽然可以想象AMFs可能是HPV感染的常见特征，但它们与细胞异型性的关联以及在高级别宫颈上皮内瘤变（CIN）中的存在表明，AMFs可能预示着存在不同于单纯扁平湿疣的病变。在本研究中，对被认为是由HPV诱导的挖空细胞性宫颈病变进行显微镜检查，以确定是否存在AMFs，并将结果与通过免疫过氧化物酶检测确定的HPV存在情况以及通过福尔根显微分光光度法测量的核DNA分布模式相关联。在最初诊断为扁平宫颈湿疣的未经选择的病变中，AMFs出人意料地常见（22.6%），并且与挖空细胞形成的程度无关。对35例有AMFs的病例进行了免疫过氧化物酶（IMPO）染色，其中74.3%的病例HPV呈阴性，22.8%呈阳性。然而，在通过IMPO评估的病例中，有丝分裂异常的存在与HPV抗原的表达呈负相关。11例中有9例（81.8%）含有AMFs的病变为非整倍体，11例中有2例（18.2%）为多倍体。在挖空细胞性宫颈病变中，异常有丝分裂象具有一系列形态和频率。虽然这些病变的生物学特性尚未明确界定，但AMFs的存在可能识别出一组HPV诱导的宫颈异型性，它们代表了扁平宫颈湿疣和CIN之间的过渡阶段。
