Papillomavirus infection of the cervix. II.

Abstract

Cases (322) of cervical dysplasia (mild, moderate and severe) and carcinoma in situ (CIS) were examined for the presence of papilloma virus structural antigens with a peroxidase-antiperoxidase method on formalin-fixed, paraffin-embedded tissue. The primary antiserum, prepared from purified, detergent-disrupted bovine papilloma virus type 1 virions, is broadly reactive against the genus-specific (common) antigen(s) of the papilloma viruses. Using the peroxidase-antiperoxidase technique on cervical tissue obtained from biopsy, conization and hysterectomy specimens, papilloma virus structural proteins were identified in association with mild dysplasia in 65 of 152 (43%) cases, with moderate dysplasia in 12 of 82 (15%) cases, with severe dysplasia in 8 of 47 (17%) cases and with CIS in 4 of 41 (10%) cases. Papilloma virus antigens were found directly within the lesion in all the cases of mild and moderate dysplasia but in only 2 instances of severe dysplasia and in none of the examples of CIS. In the remaining 10 cases of severe dysplasia and CIS associated with the presence of papilloma virus antigens, cells containing papilloma virus structural proteins were present in areas of moderate dysplasia immediately adjacent to the high-grade lesions in 7 instances and in areas of mild or moderate dysplasia not directly in contact with the high-grade lesions in 3. Among the 12 high-grade lesions associated with the presence of papilloma virus antigens, a morphologic transition from areas of moderate dysplasia containing papilloma virus antigens to the areas of severe dysplasia and CIS was present in 5 instances. The results of this study, provide direct evidence demonstrating the relationship of papilloma virus to intraepithelial cervical neoplasia ranging from mild dysplasia to severe dysplasia and CIS.