[Langerhans cells and T lymphocytes in dysplasia and cancer of the uterine cervix. An immunohistochemical study].
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Biomedical subjects
Publications and source records attributed to F Coupez.
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To evaluate the reliability of colposcopy for distinguishing flat condyloma from cervical intraepithelial neoplasia (CIN), 211 patients with abnormal cytology, colposcopical evidence of an atypical transformation zone (ATZ), and a histological diagnosis of flat condyloma or CIN were studied. Colposcopic evidence of surface abnormalities, the presence of satellite lesions, and an irregular Lugol's uptake were tentatively considered to be features of condyloma. Histologically, koilocytotic lesions with a disorganized cytologically atypical basal/parabasal layer and with atypical mitotic figures (AMFs) were considered to be CIN cases, and designated as CIN with koilocytosis (CIN K). At least two colposcopic features of condyloma found in 98 of 99 flat condylomas, were also found in 89 of 112 CINs. When colposcopic features were matched with histology for every directed biopsy site, they correlated strongly with koilocytosis, regardless of the degree of atypia in the lesion. Moreover, these features often occurred at the periphery of poorly differentiated or undifferentiated, high grade CINs, in areas histologically indistinguishable from flat condyloma. Thus, colposcopic features are not of predictive value in distinguishing flat condyloma from CIN, do not show correspondence to the lesional degree of atypia and cannot be fully related to the biological characteristics of the cervices in which they are found. These findings confirm that colposcopy cannot be considered to be a diagnostic method.
Cervical biopsies from 66 women presenting an abnormal smear, with HPV related features were studied and histologic features were correlated to the HPV type, as determined by molecular hybridisation studies. HPV DNA sequences were evidenced in 13 of 19 lesions corresponding to exophytic or flat condyloma (HPV type 16 in seven cases, HPV type 11 in four cases, as yet uncharacterized HPV types, HPV X, in two cases). Fourty biopsies were histologically interpreted as CIN, on the basis of atypical mitotic figures (AMF) and/or basal-parabasal cell atypia. HPV type 16 was evidenced in 20 cases (3 cases of double infection: HPV types 16 and 18, HPV types 16 and 33, HPV types 16 and X). In 10 other cases, HPV DNA sequences corresponding to HPV type 11 (one case), HPV 18 (one case) and HPV X (8 cases) were evidenced. In this study, potentially oncogenic HPV types (HPV 16, HPV 18, HPV 33) have been found only in CIN lesions defined on the presence of AMFs and/or basal-parabasal cells atypia. These histologic criteria seem to allow a distinction between low and high risk cervical lesions.
One hundred and seventy five CIN cases diagnosed during the years 1958-60 have been reviewed and histologic slides as well as colpographies have been reevaluated for the presence of Papillomavirus-related features. Histo-colposcopic features of HPV infection have been found in 70% of CIN cases, incidence comparable to the one actually observed. Thus, the relationship between HPVs and cervical cancer doesn't seem to be changed.
Ten years after the description of cervical flat condyloma, it is now admitted that Human Papillomaviruses (HPVs) type 6 and 11 are responsible for condylomata acuminata and typical flat condyloma of the uterine cervix. HPV DNA type 16 and, less frequently, 18, 33 and other as yet uncharacterized HPV types (G. Orth, personal communication), are found in the majority of Cervical Intraepithelial Neoplasia (CIN), Vulvar Intraepithelial Neoplasia (VIN) and cervical and vulvar invasive cancers. Since HPVs are sexually transmissible, recent interest has focused on the "male factor". Clinically detectable lesions of male genitalia are condylomata acuminata, bowenoid papulosis and flat condyloma-like papules. The aim of our study was the colposcopical screening, recently suggested, of different groups of male patients in order to detect HPV-related lesions and the description of the colposcopical features of subclinical HPV-related lesions, since most of them have never been reported, to our knowledge, in the literature. A total of 114 men were examined. Among them, 18 presented clinically detected recalcitrant condylomata acuminata, 28 had been treated for the same pathology 1 to 5 days earlier and were clinically free of lesions, 46 were sexual partners of women with cervical atypia (flat condyloma and/or CIN) and 22 had a clinical diagnosis of genital infection without HPV-related lesions. A careful examination of external genitalia was performed. Then all patients underwent penile colposcopy before and after application of 5 p. 100 acetic acid. Selected biopsies were performed in all lesions which were clinically and colposcopically different from classic warts. Colpophotographs were taken in all cases.(ABSTRACT TRUNCATED AT 250 WORDS)
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