Simultaneous effects of aneuploidy and oncogenic human papillomavirus on histological grade of cervical intraepithelial neoplasia

Objective To investigate whether ploidy and oncogenic human papillomavirus types can be correlated with the histological grade of cervical intraepithelial neoplasia (CIN) in the same tissue sections. Design Histological data were obtained from 292 dysplastic lesions of the cervix and classified according to the CIN and the Bethesda terminologies. The samples were analysed using Feulgen-stained image analysis cytometry for ploidy and Human papillomaviruses DNA typing by in situ hybridisation, respectively. Setting Colposcopy Clinic at Alfred Fournier Institute, Paris. Population Three hundred and forty women referred for an abnormal cervical smear. Results The ploidy data strongly segregate high grade from low grade squamous intraepithelial lesions (aneuploidy 78% versus 21%; P < 0.0001). There was a significant association between aneuploidy and the severity of the lesions (94% for CIN 3, 55% for CIN2 and 14% for CIN 1; P < 0.0001). Both classifications showed a significant association of histological grade with oncogenic human papillomavirus types (HPV 16-18-33: 20% in low grade and 78% in high grade squamous intraepithelial lesions, 31% and 75% in CIN 1 and CIN 3, respectively; P < 0.0001). The simultaneous effects of these viruses and ploidy demonstrate an association in aneuploid cells between the presence of oncogenic human papillomavirus types and histological grade (76% and 18% in high and low grade squamous intraepithelial lesions, respectively; P < 0.0001). Such an association was not observed in diploid cells (20% in both low and high grade squamous intraepithelial lesions). Conclusion High risk human papillomavirus types do not exert an independent effect on the histological grade of cervical intraepithelial neoplasia.