Genital Human Papillomavirus (HPV) Infections and Their Associations with Squamous Cell Cancer: Reappraisal of the Morphologic, Epidemiologic and DNA Data

摘要: The reliable assessment of epidemiology genital human papillomavirus (HPV) infections is hampered by a number technical problems. Because the lack tissue-culture systems, methods based on morphological approaches (colposcopy, cytology, and histopathology) play central role in HPV diagnosis. Even DNA-hybridization techniques recently introduced DNA amplification with PCR are extremely difficult to standardize, they thus subject major interlaboratory variation. situation further complicated complex biological behavior infections. As established long-term prospective follow-up study run Kuopio since 1981 for over 500 women, clinical progression regression seem be significantly related grade lesion when first diagnosed (p > 0.00001, p = 0.0005, respectively), as well type 0.0012). Most importantly, however, an fluctuating course, transition from manifest subclinical or latent infection frequently being encountered individual patients examined at 6-month intervals prolonged periods. This explains highly divergent prevalence figures reported different series (ranging few percent 80%), which completely dependent technique used analyze presence HPV, i.e., whether (1) PAP smear, (2) biopsy, (3) hybridization, (4) amplification. two capable disclosing only (clinical) infections, latter also ones, respectively. practical relevance, criteria defined this paper time. In unselected population 22-year-old Finnish females, was 3%, adjusted annual incidence 8%. According estimates life-time risk, up 79% females would contract least one between ages 20 79 years. When trends invasive cervical cancer Finland, it evident that risk getting HPV-infected observed 15% rate during far above (5/105, incidence) development (ie, 0.79 × 0.15 11%). A theoretical model constructed explain according lesions represented small minority (2%-5%) problem, accounting 90% all It seems clear countries where effective mass-screening programs exist (and precancerous traced), increasing not necessarily reflected increased carcinomas. long associated morphologically epithelial lesion, probably lesser significance latent). Accordingly, our attempts should focused develop accurate means predict malignant transformation those regressing spontaneously. have implications therapeutic considerations