HPV typing and cervical cancer screening: results of Moroccan critical study

ABSTRACT

Cancer of the uterine cervix, the second most frequent cancer after breast cancer in Morocco, is closely linked to several types of Human Papilloma Virus [HPV] especially the potentially oncogenic types 16 and 18 mostly found in high grade precancerous lesions and uterine cervix cancer. In the Bethesda cytological classification, HPV infection and Cervical Intraepithelial Neoplasia grade I [CIN 1] are classified as Low grade Squamous Intraepithelial Lesions [LSIL] whereas CIN 2 and CIN 3 are considered High grade Squamous Intraepithelial Lesions [HSIL]. The cytologic diagnosis of HPV infection on cervical Pap smears relies on the association of several criteria of which koilocytosis is considered specific of HPV infection. Colposcopy and direct biopsies are therefore necessary to cofirm the diagnosis. Nevertheless, since the introduction of HPV typing in uterine cervix cancer screening, koilocytosis is disregarded as a necessary criteria for the diagnosis of HPV infection. The authors report the results of a study which corroborate this statement and correlate histopathology and HPV typing of benign lesions collected at our institution [INO]. Guidelines for follow-up are also discussed according to the data in the literature