[Human papillomavirus infections of the cervix uteri. Clinical implications, indications of typing].
Recently, intense interest has focused on the relation between HPV infection and precancerous and cancerous lesions of the uterine cervix, as witnessed by the numerous publications on the subject. We carried out a prospective anatomo-clinical study on 224 HPV positive women followed in the Rene Huguenin Centre, from April 1984 to December 1988. Among these patients, cytology, colposcopy and biopsy were performed, when necessary, concurrently with the detection of HPV on cervical smears using a molecular hybridization method (G. ORTH). This study analysed the anatomo-clinical results and suggested the practical implications, taking into account the progress of the patients. These patients were followed up and treated when necessary for cervical intra-epithelial neoplasia (CIN) or carcinoma, associated or not with HPVs (oncogene in 70% of cases). 24% of this population was infected by an HPV, without any lesion. This virus disappeared spontaneously during follow-up; therefore, HPV infection even oncogene, did not necessarily carry onto CIN. Among CIN 1-2, associated or not with HPV, adequate treatment cured the patients with the virus disappearing. In some cases, a simple follow-up showed a spontaneous resolution of the lesion and of the virus. CIN 3 was removed when necessary with systematic pathological examination of the endocervix and of the surgical sample limits. In a few cases, the virus persisted without lesion. HPV infection did not modify our protocol for invasive carcinoma.(ABSTRACT TRUNCATED AT 250 WORDS)
Laval
C
C
Département de Gynécologie Médicale, Centre René-Huguenin Saint-Cloud.
Le Doussal
V
V
Pratili
M
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000382:microbiology / Q000473:pathology; D003127:Colposcopy; D003218:Condylomata Acuminata / Q000382:microbiology / Q000473:pathology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D027383:Papillomaviridae / Q000145:classification / Q000302:isolation & purification; D011230:Precancerous Conditions / Q000382:microbiology / Q000473:pathology; D014412:Tumor Virus Infections / Q000382:microbiology / Q000473:pathology*; D002577:Uterine Cervical Diseases / Q000382:microbiology / Q000473:pathology*; D002578:Uterine Cervical Dysplasia / Q000382:microbiology / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000382:microbiology / Q000473:pathology*
Les infections à papillomavirus humains (HPV) du col utérin. Implications cliniques, indications due typage.