Correlation of immunochemical detection of HPV L1 capsid protein in pap smears with regression of high-risk HPV positive mild/moderate dysplasia.
OBJECTIVE
To immunostain Pap smears of high-risk (hr) HPV DNA-positive early squamous lesions for detecting HPV L1 protein.


METHODS
Routinely stained archival slides from 84 mild and moderate hrHPV DNA-positive dysplasias were immunostained using a panreactive HPV L1 antibody. Follow-up smears were taken from women with remission for a mean period of 22.8 months (range, 6-46). Conization was done in patients with persistence or progression (3 and 48 patients, respectively) after a mean time of 12 months (range, 9-48).


RESULTS
Twenty-nine of 84 smears (34.5%) had positively stained squamous epithelial cell nuclei. In 9 of 29 (31%) women progressive disease occurred (2 cervical intraepithelial neoplasia [CIN] 2 and 7 CIN 3 lesions on conization) 20 (69%) had remission. Of the 55 L1-negative cases, 13 (23.6%) had remission, 42 (76.4%) progressed (3 CIN 2, 38 CIN 3, 1 microinvasive carcinoma). The difference in follow-up between L1 positive and negative cases was statistically significant (chi2 test, p< or =0.001).


CONCLUSIONS
Low and moderate dysplastic squamous lesions without immunochemically detectable HPV L1 protein are significantly more likely to progress than are L1-positive cases. Immunochemical L1 capsid detection in routine Pap smears thus offers prognostic information about early dysplastic lesions.
Griesser
Henrik
H
Department of Pathology, University of Wuerzburg, Wuerzburg, FRG. path023@mail.uni-wuerzburg.de
Sander
Heinz
H
Hilfrich
Ralf
R
Moser
Bettina
B
Schenck
Ulrich
U
D000328:Adult; D000367:Age Factors; D036022:Capsid Proteins / Q000032:analysis*; D002472:Cell Transformation, Viral; D018450:Disease Progression; D004848:Epithelium / Q000002:abnormalities / Q000473:pathology / Q000821:virology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000032:analysis*; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000737:chemistry / Q000235:genetics / Q000472:pathogenicity; D030361:Papillomavirus Infections / Q000175:diagnosis*; D012075:Remission, Spontaneous; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000821:virology; D014626:Vaginal Smears / Q000379:methods*; D016662:Virus Integration
D036022:Capsid Proteins; C114580:HPV L1 protein, Human papillomavirus; D009856:Oncogene Proteins, Viral