Cervical dysplasia, a premalignant lesion that can progress to cervical cancer, is caused primarily by a sexually transmitted infection with an oncogenic strain of the human papilloma virus (HPV) . Not all women with the virus develop cervical dysplasia or cervical cancer. It has been postulated that there are multiple host factors that contribute to progression of disease (smoking, oral contraceptives, diet, sexually transmitted diseases, immune response, and genetic susceptibility) .There are several methods for detection of HPV, but polymerase chain reaction (PCR) is the most sensitive molecular techniqe in detection of HPV. Since the PCR method enables rapid detection of HPV DNA, and high sensitivity and specificity, it has become possible to undertake large epidemiological studies to assess the role of HPV DNA in cervical dysplasia and cervical cancer . Aim of the study :The aim of this study is to utilize this highly sensitive PCR technique in detection of HPV in inflammatory, dysplastic & malignant uterine cervical lesions
Materials and Methods :A total of 50 tissue samples from uterine cervix were included in this retrospective study. These specimens were either hysterectomy specimens (23 cases) or punch biopsies(27cases)
There were 11 cases of chronic cervicitis, 20 cases of cervical intraepithelial neoplasia(9 cases CIN I (mild dysplasia), 6 of CIN II (moderate dysplasia), and 5 of CIN III (sever dysplasia or carcinoma in situ(CIS))), 15 cases of squamous cell carcinoma, and 4 cases of adenocarcinoma . PCR technique were performed for the detection and typing of HPV in these cervical tissue samples, the results were as follows . Results : 1) In the first round, no amplification products were detected (no DNA). 2) The second round included only 30 cases of cervical lesions of different histological types which were repeated by PCR technique, but still 6 cases from those 30 cases showed no amplification product (no DNA ) ,so only 24 cases were submitted for the statistical analysis . 3) Of the total 24 cases, 6 cases(25%) tested positive for HPV infection . 4) Non of the DNA isolated from the cervical specimens from patients with chronic cervicitis showed HPV DNA amplicons . 5) The prevalence of HPV DNA in the total group of cervical dysplasia was (44.4%) . The percentages of HPV DNA positivity were (CIN I = 0 , CIN II = 66.7% , CIN III = 50% ) . 6) The prevalence of HPV DNA in the total group of SCC was 22.2% . 7) No HPV- DNA amplicons was detected in all samples diagnosed as having adenocarcinoma . 8) PCR typing of HPV DNA detected in the 6 cases of cervical lesions(4 cases of CIN, and 2 cases of SCC) revealed negative results (i.e they did not belong to any type of HPV submitted in this study (un typable HPV) . Conclusion : PCR is a high sensitive molecular technique for detection of HPV in different lesions of uterine cervix . -Positive HPV was detected in 6 cases (25%) of the total 24 cases of different cervical lesions submitted to this technique . - Four cases (44.4%) of CIN , and two cases (22.2%) of SCC were positive for HPV in this study . -Negative HPV typing results , were most propably due to untypable HPV .