Strand A, Rylander E, Wilander E, Zehbe I, Kraaz W
Department of Dermatology, University Hospital, Uppsala, Sweden.
Sex Transm Dis. 1996 Jul-Aug;23(4):293-8. doi: 10.1097/00007435-199607000-00009.
Guidelines for the histopathologic diagnosis of human papillomavirus (HPV) infection have been drawn from changes seen in cervical specimens not necessarily applicable to penile epithelium.
To evaluate histopathologic examination as a means of diagnosing HPV infection of the male genital tract.
Ninety-two consecutive male patients seen at the sexually transmitted diseases clinic. Twelve had condyloma acuminatum, and 80 had papular lesions, macular lesions, or both. Fifteen men without signs of HPV infection served as controls. Biopsy specimens were evaluated morphologically by light microscopy, and HPV DNA detection was performed by in situ hybridization and polymerase chain reaction.
All acuminate lesions were HPV DNA positive with in situ hybridization. Forty papular and/or macular lesions harbored HPV DNA, 28 (35%) of them positive with in situ hybridization and the other 12 (15%) positive with polymerase chain reaction. Morphologic signs attributed to HPV infection were found in HPV-positive and HPV-negative penile lesions, as well as in normal epithelium. In papular and macular lesions, the only criterion associated with HPV DNA positivity was neoplastic changes, which was present in 16 (40%) HPV DNA-positive specimens, compared to 4 (10%) HPV DNA-negative specimens (P < 0.01). Of the 16 lesions with neoplasia, 15 (94%) had detectable HPV DNA of a potentially oncogenic type.
Histopathologic signs of HPV infection other than neoplasia seem to be of limited value. Detection of the infectious agent, in this case HPV, should be the gold standard for the diagnosis as it is for other infectious diseases. The strong association between neoplasia and potentially oncogenic HPV types makes this issue even more important.
人乳头瘤病毒（HPV）感染的组织病理学诊断指南是从宫颈标本中观察到的变化得出的，不一定适用于阴茎上皮。
评估组织病理学检查作为诊断男性生殖道HPV感染的一种方法。
对性病门诊连续就诊的92例男性患者进行研究。其中12例患有尖锐湿疣，80例有丘疹性病变、斑疹性病变或两者皆有。15名无HPV感染迹象的男性作为对照。活检标本通过光学显微镜进行形态学评估，并通过原位杂交和聚合酶链反应进行HPV DNA检测。
所有尖锐性病变通过原位杂交检测HPV DNA均为阳性。40例丘疹性和/或斑疹性病变中检测到HPV DNA，其中28例（35%）通过原位杂交呈阳性，另外12例（15%）通过聚合酶链反应呈阳性。在HPV阳性和阴性的阴茎病变以及正常上皮中均发现了归因于HPV感染的形态学特征。在丘疹性和斑疹性病变中，与HPV DNA阳性相关的唯一标准是肿瘤性改变，16例（40%）HPV DNA阳性标本中存在这种改变，而HPV DNA阴性标本中仅有4例（10%）存在（P<0.01）。在16例有肿瘤形成的病变中，15例（94%）检测到具有潜在致癌性的HPV DNA。
除肿瘤形成外，HPV感染的组织病理学特征似乎价值有限。对于这种情况即HPV感染，检测感染因子应作为诊断的金标准，就如同对其他传染病一样。肿瘤形成与潜在致癌性HPV类型之间的强关联使得这个问题更加重要。
