Prospective follow‐up of Japanese women with cervical intraepithelial neoplasia and various human papillomavirus types

Objective: To evaluate the prevalence of genital human papillomavirus (HPV) types in cervical neoplasias and to evaluate the biological activity of individual HPV types in cervical carcinogenesis. Method: Cellular samples from 318 patients with cervical intraepithelial neoplasia (CIN) or invasive cervical carcinoma were examined for HPV DNA, using a polymerase chain reaction. Of these, 145 women with CIN grade I or II were prospectively followed to better understand the natural history of these precancerous lesions. Result: HPV DNA was detected in 88, 80 and 89%, of CIN grade I, II and III, respectively, and in 92% in invasive carcinomas. The CIN follow-up data showed a significantly higher progression rate in patients with CIN II than in cases of CIN I, and our classification of HPV types based on HPV prevalence data correlates well with the prospective follow-up data. A significantly higher progression rate was observed in HPV-negative CINs. Conclusion: Classification of HPV types according to risk to a malignant state seems to be possible. It seems that HPV negative lesions are likely to progress to a malignant state.