Study of the proliferative activity of various premalignant & malignant cervical lesions with a correlation to HPV status

Preinvasive & invasive cervical lesions are a major public health concern, though it is a preventable problem to a great extent. At present few reports have been published concerning the variability of proliferative activity in cervical biopsy in women with cervical neoplastic damage. Again though the association between HPV & neoplastic cervical lesions is well known, only a few studies have been published comparing the status of HPV with proliferative activity in south Bengal, India. The objectives of present study is to find the association of HPV status &proliferative activity (AgNOR count) in premalignant & malignant cervical lesions & to help the clinicians &histopathologists in cases of diagnostic dilemma. A study was conducted in 50 women residing in south Bengal. The patients were divided into two groups: Control group (patients with chronic cervicitis=8) & study group (patients with premalignant & malignant cervical lesions=42).HPV-16 status was determined by DNA PCR. AgNOR staining was performed according to standard guidelines. Counting the number & shape of AgNOR was done under 100 x objectives in 100 cells in each slide & mean AgNOR count obtained. Statistical significance was established at P< 0.05. The mean percentage of HPV positivity increased significantly with severity of lesions (P=0.004). Proliferative activity of various cervical lesions was also significantly associated with HPV status (P=0.0048). HPV positivity was seen to be significantly associated with age at menarche (p=0.0265) & age at first pregnancy (p=0.019). In present study, a direct association of proliferative activity with HPV status was found.