Virological and biological characteristics of cervical intraepithelial neoplasia grade I with marked koilocytotic atypia.
The aim of this study was to evaluate virologic and biological significance of marked koilocytotic atypia observed in some cases of grade I cervical intraepithelial neoplasia (CIN I). Thirty-one CIN I cervical biopsy specimens with marked koilocytotic atypia, defined by the presence of meganuclei in the superficial epithelial layers, were compared to 37 CIN I biopsy specimens with usual koilocytes for (1) the human papillomavirus (HPV) type and signal pattern as detected by nonisotopic in situ hybridization (ISH); (2) the proliferation index assessed by Ki 67 immunostaining and (3) the p53 labeling pattern. Interobserver agreement for meganuclei was excellent (k = 0.9). Twenty-five out of 68 biopsies (37%) were positive by ISH for the 6 of 11 HPV probe, 30 (44%) for the 16-18 probe, and 7 (10%) for the 31/33 HPV probe, 6 (9%) were negative for ISH. The presence of meganuclei was strongly related to high and intermediate risk HPV type (P = 0.0001). The sensitivity and specificity of meganuclei for the detection of high or intermediate risk HPV in CINI were 73 and 87%, respectively. Loss of p53 immunostaining in the lower third of the epithelium was also related to the presence of meganuclei (P < .05), but the MIB-1 index and ISH labeling pattern were not. In conclusion, marked koilocytotic atypia in CIN I is a reliable and sensitive marker for infection by high or intermediate-risk HPV, and might be a guide to therapy.
Department of Pathology, Jean Verdier Hospital, Bondy, France.
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M
Ziol
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C
Di Tomaso
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A
Biaggi
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Tepper
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Piquet
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L
Carbillon
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Uzan
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C
Guettier
D034961:Antigens, Nuclear; D001324:Autoantigens / Q000032:analysis; D015415:Biomarkers / Q000032:analysis; D001706:Biopsy; D005260:Female; D006801:Humans; D017403:In Situ Hybridization; D019394:Ki-67 Antigen; D009367:Neoplasm Staging; D009687:Nuclear Proteins / Q000032:analysis; D016159:Tumor Suppressor Protein p53 / Q000032:analysis; D002578:Uterine Cervical Dysplasia / Q000473:pathology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology*; D014626:Vaginal Smears
D034961:Antigens, Nuclear; D001324:Autoantigens; D015415:Biomarkers; D019394:Ki-67 Antigen; D009687:Nuclear Proteins; D016159:Tumor Suppressor Protein p53