Kühler-Obbarius C, Milde-Langosch K, Löning T, Stegner H E
Department of Gynecological Pathology and Electron Microscopy, University of Hamburg, Germany.
Acta Cytol. 1994 Sep-Oct;38(5):681-6.
Between January 1991 and 1992, 5,652 cervical smears from 4,918 women were classified according to the traditional Papanicolaou/cervical intraepithelial neoplasia (CIN) categories and to the recently developed Bethesda System. Koilocytosis without atypia was identified in 3.7% (183 cases), CIN 1 in 1.8% (87 cases) and high grade squamous intraepithelial lesions (SILs) (CIN 2 and 3) in 1.9% (93 cases) (total, 363/4,918 = 7.4%). Human papillomavirus (HPV)-directed polymerase chain reaction analysis with general primers and subsequent hybridization with HPV 16/18 probe cocktail was carried out in 35% of cases with koilocytosis and dysplasia of any degree (127/363 cases). Seventy-five percent (95 cases) were positive in contrast to a detection rate of 30.8% (53/172 cases) for nonsuspicious smears. While low grade SILs were HPV positive in 67% (koilocytosis only) and 75% (CIN 1), high grade SILs harbored HPV in 87%. The rate of HPV 16/18 infections varied from 71.9% in low grade SILs to 88.9% in high grade SILs. Our results point to the questionable value of koilocytosis as a specific marker of HPV infection and call for confirmatory tests prior to classifying cervical smears suggestive of HPV infection in the low grade SIL category.
1991年1月至1992年期间，对4918名女性的5652份宫颈涂片按照传统巴氏/宫颈上皮内瘤变（CIN）分类法以及最近制定的贝塞斯达系统进行了分类。未发现异型性的挖空细胞占3.7%（183例），CIN 1占1.8%（87例），高级别鳞状上皮内病变（SILs，CIN 2和3）占1.9%（93例）（总计363/4918 = 7.4%）。对35%存在任何程度挖空细胞和发育异常的病例（127/363例）进行了人乳头瘤病毒（HPV）定向聚合酶链反应分析，并随后与HPV 16/18探针混合物进行杂交。75%（95例）呈阳性，相比之下，非可疑涂片的检测率为30.8%（53/172例）。低级别SILs中HPV阳性率为67%（仅挖空细胞）和75%（CIN 1），高级别SILs中HPV携带率为87%。HPV 16/18感染率从低级别SILs中的71.9%到高级别SILs中的88.9%不等。我们的结果表明挖空细胞作为HPV感染特异性标志物的价值存疑，并呼吁在将提示HPV感染的宫颈涂片分类为低级别SIL类别之前进行确诊试验。
