Significance of Morphometric Analysis of HPV-Induced Cervical Dysplasia

Abstract

Introduction/ Background Genomic integration of high-risk human papilloma virus in the nucleus of cervical epithelial mucosal cells leads to epithelial dysplasia.

Aims The aim of this study was to establish the significance of morphometric analysis of the nuclear area in the assessment of the degree of cervical dysplasia.

Methods This study included 85 women with primary, previously untreated lesions, and colposcopic findings indicating dysplasia, in whom a cytological test by Papanicolaou method was interpreted according to the Bethesda criteria as low-grade squamous intraepithelial lesion (LSIL), high-grade squamous intraepithelial lesion (HSIL), and atypical squamous cells of undetermined significance (ASCUS). We performed human papiloma virus (HPV) typing by PCR for evidence of viruses’ types 16, 18, 31, 33. After biopsy of the cervical mucosa, we performed hematoxylin-eosin (H-E) and morphometric analysis of tissue samples. Morphometric analysis was performed on H&E stained slides at 400 x magnification. We analyzed four representative fields of dysplasia; 70 nuclei were photographed, using a digital optical microscope (Nikon Coolscope, Japan) and the morphometric computer program. The control group consisted of 10 women without dysplasia and without a verified infection of cervical high-risk HPV.

Results A high statistical correlation between the degree of dysplasia and the area of nuclei at different degrees of cervical dysplasia (p = 0.000). The high-grade cervical dysplasia had a more than 2-fold higher level of ranking in comparison to low-grade dysplasia, and a more than 10-fold higher ranking than the control group without cervical dysplasia. Our results suggest that the use the morphometric analysis is useful in the assessment of cervical epithelial dysplasia.