No abstract

Aim-To determine the size of a cervical biopsy specimen with human papillomavirus (HPV) infection required to enable in situ hybridisation to be carried out with a guarantee of a reliable result. Methods-In situ hybridisation was carried out in 142 cervical uterine biopsy specimens classified histologically as low grade and high grade squamous intraepithelial lesions. Epithelial length at the level of the basal membrane was measured by image analysis. The specimens were divided into 10 groups based on epithelial length. Results-Of the biopsy specimens, 61-2% were HPV positive. In specimens with an epithelial length below 5 mm 31-9% were HPV positive; in those between 5 and 9 mm in length 67*5% were HPV positive; and in those greater than 9 mm in length 81-8% were positive for HPV. For low grade squamous intraepithelial lesions (n = 90), 68*4% of specimens with an epithelial length greater than 5 mm were HPV positive. For high grade squamous intraepithelial lesions (n = 52), 86-8% of specimens with an epithelial length greater than 5 mm were HPV positive. Conclusions-For a diagnosis of HPV infection using in situ hybridisation, the minimum length of epithelium in a cervical biopsy specimen should be 5 mm. For high grade squamous intraepithelial lesions, specimens over 5 mm in length are suitable. For low grade squamous intraepithelial lesions, to minimise the number of false negative results, the ideal minimum length is 10 mm.

No abstract

No abstract

In the study of infection of the lower female genital tract caused by human papillomavirus (HPV), one of the main concerns is the search for prognostic factors to predict the evolution of premalignant low‐ and high‐grade squamous intraepithelial lesions. This study has evaluated the prognostic usefulness of the patterns of positive reaction obtained by non‐isotopic in situ hybridization (NISH), referred to as diffuse, punctate, or mixed ‘labelling patterns’. The study examined 141 vulvar and uterine cervical biopsy specimens that were positive for HPV by a NISH screening technique and that had the following histological diagnoses: low‐grade squamous intraepithelial lesion (LSIL; n=87); high‐grade squamous intraepithelial lesion (HSIL, n=40); and squamous cell carcinoma (SCC n=14). Typing of all the specimens was carried out by NISH with DNA probes specific for HPV types 6/11 (low risk), 16/18 (high risk), and 31/33/51 (intermediate risk), and the labelling pattern observed in each specimen was recorded. Statistical analysis of the results showed that there was a significant difference in the distribution of labelling patterns, both by lesion diagnosis (P≤0·004) and by infecting viral type (P≤10−6). Lesions with a punctate or mixed pattern are considered more likely to undergo malignant evolution and consequently have a worse prognosis than lesions with a diffuse pattern.