1997 Volume 36 Issue 2 Pages 157-162
The Bethesda system puts Human Papilloma Virus (HPV) infection and mild dysplasia in the same category as low-grade squamous intraepithelial lesions (SIL). This report cytologically reviews 74 cases of HPV infection (Group A), 61 cases of mild dysplasia (Group B) and 40 cases of mild dysplasia+HPV infection (Group C). The aim was as to evaluate the adequacy of regarding HPV infection and mild dysplasia as being equivalent clinically and cytopathologically. Patients underwent punch biopsy with colposcopy.
1. A comparison of accuracy rates between cytology and pathology yielded 39.2%, 45.9% and 67.5% in groups A, B and C, respectively.
Group C had a significantly higher rate than the other two (p<0.05).
2. According to the Bethesda system, the rates of combined high-grade SIL lesions in each gruop (A, B, C) were 13.5%, 14.8% and 15.0%, respectively (p: NS).
3. HPV infection cases with high-grade SIL lesions showed dyskaryotic cells with slightly anisokaryotic nuclei, and cytoplasms were strongly stained with OG. Structures of the nuclei were unclear but not smudged (resembling moderate dysplasia, keratinizing type ; WHO teaching slide no. 79). These results suggest that HPV infection and mild dysplasia are cytologically equivalent, and it is a noteworthy that dyskaryotic cells (mentioned above) are usually seen in HPV infection combined with high-grade SIL lesions.
