The prevalence of human papilloma virus (HPV) DNA in different histological subtypes of cervical adenocarcinoma and related tumors was examined using formalin-fixed, paraffin-embedded tissue samples from 105 primary cervical adenocarcinomas and adenosquamous carcinomas. Broad-spectrum HPV DNA amplification and genotyping was performed with the SPF10 primer set and line probe assay (LiPA), respectively. HPV DNA was detected in 82 of 90 (91%) mucinous adenocarcinomas, encompassing endocervical, intestinal, and endometrioid histological subtypes, and in nine of nine adenosquamous tumors (100%). HPV DNA was not detected in any nonmucinous adenocarcinomas including clear cell, serous, and mesonephric carcinomas (0/6). The most common viral types detected in adenocarcinoma were HPV 16 (50%) and HPV 18 (40%), followed by HPV 45 (10%), HPV52 (2%), and HPV 35 (1%). Multiple HPV types were detected in 9.7% of the cases. Adenocarcinoma of the cervix (AdCx) accounts for approximately 15% of cervical cancers and has been increasing in incidence during the last few decades, particularly in younger women. 1 The etiology of squamous cell carcinoma of the cervix, the most common type of cervical malignancy, is linked to infection with oncogenic types of human papillomavirus (HPV), but the pathogenesis of AdCx is less well understood. Although HPV DNA is consistently detected in Ͼ90% of squamous cell carcinomas of the cervix, 2 the reported prevalence of HPV DNA in AdCx varies significantly, from 32% to 100%, depending on the detection method used. [3][4][5][6][7][8][9][10][11][12][13]
This paper reports colpomicroscopic observations on 750 patients with abnormal Papanicolaou smears and delineates the diagnostic criteria used in colpomicroscopy. The detection rate in a prospective series of 100 women was 84% and the diagnostic accuracy 68%. Of special interest in this study was a group of patients who had a minute area of mild dysplasia found on the squamous side of the squamo‐columnar junction. Each of these areas was unifocal and was associated with a smear in which the abnormal cells were derived from the superficial and upper intermediate layers.
HPV DNA testing has a sensitivity equivalent to, or better than, that of cytology. Since HPV DNA testing programs may be easier to implement than cytologic screening, HPV testing should be considered for primary cervical cancer screening in low-resource settings.
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