Human papillomavirus-related cervical lesions in adolescents: a histologic and morphometric study.

OBJECTIVE

To evaluate the cytopathic effect of human papillomavirus (HPV) infection in adolescents.

METHODS

Cervical biopsies from 100 patients, 50 from adolescents age 14 to 20 and 50 from mature women age 35 to 64, all diagnosed with HPV-related lesions (condylomas), were studied histologically and morphometrically. Fifty were associated with low-grade squamous intraepithelial lesions and 50 with high-grade squamous intraepithelial lesions.

RESULTS

Epithelial cells with large hyperchromatic, often bizarre-shaped, nuclei, staining positive for HPV-16, were identified in most samples from adolescents. These nuclei were, on average, almost twice as large as those seen in biopsies from older women (P = 0.003), and they mostly occupied the lower half of the epithelium (P = 0.0008). These large cells were further analyzed for texture by a novel image-analysis approach, the autocorrelation factor beta, that revealed a markedly different, smoother nuclear structure, suggestive of a large viral load, different from the irregular chromatin pattern seen in dysplastic nuclei.

CONCLUSIONS

These peculiar nuclei were ubiquitous in the adolescent cervical biopsies and probably represent a primary abundant productive viral infection. They should not necessarily be interpreted as dysplastic.