Morphological features of HPV infection and the relationship between HPV subtypes and clinicalpathological characteristic of cervical cancer

Objective To observe the morphological features of cervical squamous cell carcinomas with HPV infection, and to explore the relationship between morphology of HPV subtypes and clinicopathological characteristics of cervical. Methods A total of 594 cases of cervical squamous cell carcinoma were observed. HPV was detected by SPF-10 PCR, subsequently followed by DNA enzyme immunoassay （DEIA） and genotyping by line probe assay （LiPA）. Resuits Out of 581 HPV DNA positive cases, 394 were found to be with typical koilocytes （n = 104） or atypical koilocytes （n = 290）, which was the morphological hallmark of HPV infection. The detection rate was 67. 8%. Typical koilocytes were found in 36. 2% keratinizing and 72.2% of well differentiated cervical squmaous cell carcinoma, but was not found in 34.0% of non-keratinizing and 50. 7% of poorly differentiated ones. The most common HPV type was HPV16 （453 cases）, followed by HPV 18 （43 cases）. The other high-risk HPV subtype were HPV 31, 52, 59, 58, 39, 45, 33, 56, 66, 68 and 73, and each subtype had 17, 12, 12, 11, 6, 5, 5, 3, 2, 1 and 1 cases, respectively. Low-risk HPV included HPV 6 （ n = 1 ） and HPV 53 （ n = 1 ）. Another 8 cases were HPV DNA positive, but their subtypes cannot be identified. Patients infected with HPV 16 or HPV 18 were younger than those infected with other high-risk HPV. The percentage of cases without koilocytes was higher for HPV 18 （48. 8% ） than for HPV 16 （31.8%） positive ones. Conclusion The morphology of koilocytes is closely related to the differentiaon of cervical squmaous cell carcinomas. Typical koilocytes are always found in well differentiated cervical squmaous cell carcinomas, and is absent in poorly differentiated ones. HPV 16 and HPV 18 are the most important but also the most dangerous HPV subtypes. Tumor may have higher malignancy when HPV 18 is positive.