title: Defining the validity of classical and non-classical cellular changes indicative of low-grade squamous intraepithelial lesion encompassing human papillomavirus infection in relation to human papillomavirus deoxyribonucleic acid testing.
abstract: BACKGROUND
  Human papillomavirus (HPV) infection as of now has been beyond doubt to be the causative agent for cervical carcinoma. Its morphological identification in Pap smear is important.
  
  
  OBJECTIVE
  To define the validity of classical and non-classical cellular changes indicative of low-grade squamous intraepithelial lesion (SIL) encompassing HPV infection in relation to positivity for 'high risk' HPV16 as well as for 'low risk' HPV6/11.
  
  
  METHODS
  A total of 3000 Papanicolaou smears were screened, of which 150 were reported as low grade-SIL encompassing HPV infection (LSIL-HPV). Subsequently cervical scrapes from these 150 subjects, along with equal number of normal women as controls, were collected and processed for HPV deoxy-ribonucleic acid testing by polymerase chain reaction (PCR).
  
  
  RESULTS
  ON THE BASIS OF CYTOMORPHOLOGICAL CHARACTERISTICS IN PAP SMEARS, HPV INFECTION WERE CATEGORIZED INTO THE FOLLOWING TWO GROUPS: Classical (koilocytic) changes (CC) encountered in 30 women and non-classical changes (NCC) encountered in 120 women. It was observed that 21 (70%) CC and 46 (38.3%) NCC of HPV infection were positive for HR-HPV16; however only 12 cases (10%) of NCC and two cases (6.6%) of CC were positive for LR-HPV 6/11. Majority (41.7%) of HPV positive cases were reported in the age group of 25 to 30 years and HPV positivity decreased with the increasing age.
  
  
  CONCLUSIONS
  Classical cellular changes are not the only diagnostic features for HPV infection in Pap smear, non-classical diagnostic features also support the diagnosis of HPV infection and may be positive for HR-HPV16.
authors.affiliation: Department of Cytology, Institute of Cytology and Preventive Oncology (DHR), Noida, UP, India.
authors.forename: Veena
authors.initials: V
authors.lastname: Kashyap
authors.forename: Suresh
authors.initials: S
authors.lastname: Hedau
authors.forename: Suresh
authors.initials: S
authors.lastname: Bhambhani
references.citation: Int J STD AIDS. 2005 Aug;16(8):528-37
references.pmid: 16105186
references.citation: Diagn Mol Pathol. 1998 Jun;7(3):158-63
references.pmid: 9836071
references.citation: Pathol Res Pract. 2001;197(10):677-82
references.pmid: 11700889
references.citation: Cytopathology. 2005 Feb;16(1):13-21
references.pmid: 15859310
references.citation: APMIS. 1997 Jan;105(1):71-5
references.pmid: 9063504
references.citation: J Adolesc Health. 2008 Oct;43(4 Suppl):S5-25, S25.e1-41
references.pmid: 18809145
references.citation: J Pediatr. 1992 Aug;121(2):307-11
references.pmid: 1322456
references.citation: Acta Cytol. 2002 Jul-Aug;46(4):630-2
references.pmid: 12146021
references.citation: J Med Virol. 1992 Apr;36(4):239-45
references.pmid: 1315836
references.citation: JAMA. 2002 Apr 24;287(16):2114-9
references.pmid: 11966386
references.citation: J Gen Virol. 1992 Sep;73 ( Pt 9):2327-36
references.pmid: 1328489
references.citation: Eur J Obstet Gynecol Reprod Biol. 1996 Mar;65(1):45-53
references.pmid: 8706956
references.citation: Acta Cytol. 1987 Nov-Dec;31(6):855-65
references.pmid: 2827414