Genital Human Papillomavirus Infections: Correlation of Cytological, Colposcopic and Histological Features with Viral Types in Women and Their Male Partners

Abstract

To determine the incidence of anogenital papillomavirus infections and to assess the value of available diagnostic methods, we compared the cytological, colposcopic and histological features of anogenital papillomavirus-related lesions with their associated human papillomavirus types (HPV) in 300 women and in their male partners. HPV-type deoxyribonucleic acid was detected by blot hybridization in 398 out of 624 subclinical and clinically defined anogenital lesions. Whatever the site of the lesion, condylomas and low-grade intraepithelial neoplasia (IEN) were found in 84% of lesions associated with HPV 6–11, compared with 32% of lesions containing HPV 16–18 ( P<0.001). Among the HPV 16–18 associated lesions, high-grade cervical, vaginal, vulvar and anal intraepithelial neoplasias represented 45% ( P<0.001) of the lesions. In 65% of 23 cases of squamous anogenital cancer, HPV 16–18 and mixed types were present ( P<0.001). In 54% (161/300) of cases, the lesions were multicentric (161/300). On cytological examination, 27% of the samples gave false negative results. In cervical lesions, there was a good correlation between virological and colposcopic findings, but this was not true for extracervical mucous epithelia in the vagina or on the vulva. With peniscopy in the male partners 220 out of 410 had penile condylomatous lesions and more than half of the 350 male specimens examined by molecular hybridization contained HPV DNA. A correlation was found between the virus types in penile lesions or in cells of the distal urethra and in the cervical lesions of the sexual partner. We concluded that in the majority of cases of cervical lesions there is a correlation between the type of HPV DNA identified by blot hybridization and the cytohistocolposcopic findings. In practice, viral typing may be indicated in cases of colpohistologic discordance and in condyloma low-grade CIN that cannot be distinguished from presumably innocuous human papillomavirus infection.