DNA hybridization for human papillomavirus (HPV) in cervical lesions. Relationship of the presence of various viral subtypes to expression of HPV structural proteins, involucrin, and carcinoembryonic antigen.

We studied cervical tissue from 20 patients with a variety of condylomatous, preneoplastic, and neoplastic lesions to detect various subtypes of human papillomavirus (HPV) at the molecular level by DNA hybridization. In addition, mirror image biopsy specimens were studied by an immunoperoxidase technique for the presence of HPV structural antigens, carcinoembryonic antigen (CEA), and involucrin, as markers of disturbed maturation and/or neoplasia. Of the 20 patients studied, we were able to demonstrate the presence of either HPV 16 or 18, or both, in three of seven squamous carcinomas tested, and three of five dysplasias. Interestingly, two cases of squamous carcinoma and one moderate dysplasia demonstrated HPV types 6 and 11 concurrently with HPV 16 and/or 18. Four of six condylomas showed HPV subtypes 6/11, and only one condyloma showed weak hybridization with HPV 18. Human papillomavirus structural antigen was seen in three of eight condylomas, and three of five dysplasias, but not in any carcinoma. All condylomas showed intense staining for involucrin in full-thickness of the epithelium, but the high-grade dysplasias and carcinomas showed only focal or absence of staining for involucrin. Carcinoembryonic antigen was expressed in 50% of the carcinomas with a pattern similar to that seen with involucrin, but did not correlate with any particular subtype of HPV. The molecular hybridization method seems to be superior for the detection of HPV lesions, and possibly for the prediction of their biologic behavior.