title: Clinicopathological implications of human papilloma virus (HPV) L1 capsid protein immunoreactivity in HPV16-positive cervical cytology.
abstract: BACKGROUND
  The objective of this study was to investigate the expression of human papilloma virus (HPV) L1 capsid protein in abnormal cervical cytology with HPV16 infection and analyze its association with cervical histopathology in Korean women.
  
  
  METHODS
  We performed immunocytochemistry for HPV L1 in 475 abnormal cervical cytology samples from patients with HPV16 infections using the Cytoactiv(®) HPV L1 screening set. We investigated the expression of HPV L1 in cervical cytology samples and compared it with the results of histopathological examination of surgical specimens.
  
  
  RESULTS
  Of a total of 475 cases, 188 (39.6%) were immunocytochemically positive and 287 (60.4%) negative for HPV L1. The immunocytochemical expression rates of HPV L1 in atypical squamous cells of unknown significance (ASCUS), low-grade squamous intraepithelial lesions (LSIL), high-grade squamous intraepithelial lesions (HSIL), and cancer were 21.8%, 59.7%, 19.1%, and 0.0%, respectively. LSIL exhibited the highest rate of HPV L1 positivity. Of a total of 475 cases, the multiple-type HPV infection rate, including HPV16, in HPV L1-negative cytology samples was 27.5%, which was significantly higher than that in HPV L1-positive cytology samples (p = 0.037). The absence of HPV L1 expression in ASCUS and LSIL was significantly associated with high-grade (≥ cervical intraepithelial neoplasia [CIN] 2) than low-grade (≤ CIN1) histopathology diagnoses (p < 0.05), but was not significantly different between HPV16 single and multiple-type HPV infections (p > 0.05). On the other hand, among 188 HPV L1-positive cases, 30.6% of multiple-type HPV infections showed high-grade histopathology diagnoses (≥ CIN3), significantly higher than the percentage of HPV16 single infections (8.6%) (p = 0.0004) CONCLUSIONS: Our study demonstrates that the expression of HPV L1 is low in advanced dysplasia. Furthermore, the absence of HPV L1 in HPV16-positive low-grade cytology (i.e., ASCUS and LSIL) is strongly associated with high-grade histopathology diagnoses. The multiplicity of HPV infections may have an important role in high-grade histopathology diagnoses (≥ CIN3) in HPV L1-positive cases.
authors.affiliation: 1. Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
authors.forename: Sung-Jong
authors.initials: SJ
authors.lastname: Lee
authors.affiliation: 2. Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ah-Won
authors.initials: AW
authors.lastname: Lee
authors.affiliation: 2. Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Chang-Suk
authors.initials: CS
authors.lastname: Kang
authors.affiliation: 3. Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Jong-Sup
authors.initials: JS
authors.lastname: Park
authors.affiliation: 1. Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
authors.forename: Dong-Choon
authors.initials: DC
authors.lastname: Park
authors.affiliation: 3. Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Eun-Young
authors.initials: EY
authors.lastname: Ki
authors.affiliation: 3. Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Lee
authors.affiliation: 1. Department of Obstetrics and Gynecology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea.
authors.forename: Joo-Hee
authors.initials: JH
authors.lastname: Yoon
authors.affiliation: 3. Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Soo-Young
authors.initials: SY
authors.lastname: Hur
authors.affiliation: 2. Department of Hospital Pathology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Tae-Jung
authors.initials: TJ
authors.lastname: Kim
mesh_terms: D000328:Adult; D044466:Asian People; D036022:Capsid Proteins / Q000276:immunology* / Q000378:metabolism; D005260:Female; D052162:Human papillomavirus 16 / Q000472:pathogenicity; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000276:immunology* / Q000378:metabolism; D030361:Papillomavirus Infections / Q000473:pathology / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*
chemical_list: D036022:Capsid Proteins; D009856:Oncogene Proteins, Viral; C063317:L1 protein, Human papillomavirus type 16
keywords: cervical cancer; cervical cytology; cervical intraepithelial neoplasia; human papillomavirus; immunocytochemistry