Koilocytotic lesions of the cervix: the interrelation of morphometric features, the presence of papilloma-virus antigens, and the degree of koilocytosis.

We studied the interrelation of morphometric features, the presence of human papilloma virus antigens (localized by the immunoperoxidase method), and the degree of koilocytosis in koilocytotic cervical intraepithelial neoplasia. We determined the morphometric features of the cells from the deep, the middle, and the superficial layers of the affected koilocytotic epithelium and in non-koilocytotic immature metaplasia and squamous cervical epithelium. This approach allows quantification of disturbances of maturation in cervical epithelium. Our quantitative findings support the contention of other authors that human papilloma virus infection is associated with a morphologically distinct lesion, which forms a morphological continuum with neoplasia. It can be argued that, in addition to the degree of koilocytosis, nuclear enlargement and excessive cellular enlargement in the middle layer of the affected epithelium are viral-related effects. With increasing immaturity of the cervical intraepithelial neoplasia all investigated viral-related changes are less prominent. These findings suggest that in neoplastic transformation the morphological and antigen expression of human papilloma virus infection is suppressed.