Correlation between histopathological criteria of Human Papilloma Virus infection and the presence of HPV in paraffin-embedded cervical biopsies based on PCR assay

Introduction: This study was carried out to correlate histological findings in cervical lesions to human papilloma virus (HPV), as detected by polymerase chain reaction (PCR). Methods: In this descriptive study, out of 143 cervical biopsies, 50 biopsies, containing sufficient histopathologic criteria, were examined. PCR assay was performed with the primers GP05/06+ and, as control, the beta-globin gene was amplified. The morphological findings were correlated to HPV positivity: koilocytic atypia, multinucleation, acanthosis, papillomatosis, dyskeratotic cell, mitosis in the lower basal third of the epithelium, hyperplasia of basal layers. Results: In 50 selected samples pathologic diagnosis was chronic cervicitis in 37 cases (74%) and cervical intraepithelial neoplasia (CIN) in 13 cases (including CIN I in 6 cases, CIN II in 5 cases, CIN III in 2 cases). HPV DNA was positive in 6 cases, including 5.4% of chronic cervicitis (2 cases) and 30.8% of CINs (including 33.3% of CIN I, 40% of CIN II). The analysis did not indicate any strong relationship between morphological criteria and HPV. The only finding showed an independent, straight and weak correlation between HPV and koilocytic atypia (P value=0.003 & Kappa=0.296) with sensitivity of 100% and a relatively low specificity of 63.6%. By excluding mild koilocytic atypia, this correlation was amplified (P<0.001 & Kappa=0.669) and appear acceptable sensitivity of 83.3% and specificity of 93.2%. The finding with highest positive and negative predictive value was the presence of definite koilocytosis (PPV=62.5% & NPV=97.6%). Conclusion: In spite of association of some HPV infection with chronic cervicitis there is no correlation between severity of chronic cervicitis and HPV infection. Although koilocytosis is a good indicative criterion for HPV infection nevertheless, there is some limitations in histological diagnosis of cervical HPV infection