Analysis of individual cervical human papillomavirus types in neolasia: A possible role for type 18 in rapid progression

Histologic and molecular analyses of 214 cervical biopsy specimens were performed to test the hypothesis that certain individual human papillomavirus types that are usually grouped together are differentially distributed in various grades of cervical intraepithelial neoplasia and invasive squamous carcinoma. Specifically, types 16 and 18, which are commonly grouped together, were analyzed separately and compared. Biopsies obtained from three different geographic sites in the United States and Brazil were analyzed by Southern blot hybridization and correlated with the histologic diagnosis from the same tissue sample. There was a highly significant correlation between papillomavirus type and histologic grade comparing all grades of cervical intraepithelial neoplasia with invasive cancer (p < 0.001). Of particular interest was the striking deficit of type 18 in, intraepithelial neoplasia (3%) as compared with invasive carcinoma (22%; p < 0.001). In contrast, there was no significant difference in the distribution of type 16 in intraepithelial neoplasia (37%) as compared with invasive carcinoma (41 %). The deficit of type 18 in intraepithelial neoplasia compared with invasive carcinoma could represent a rapid transit time through the precursor stage. Human papillomavirus type 18 may therefore play a role in the development of rapidly progressive cervical cancer.