A study of the relationship between nuclear contour thickening, nuclear enlargement and human papillomavirus infection in squamous cells.

Abstract

To investigate the relationship between the morphological features of nuclear enlarged cells and human papillomavirus (HPV) infection in negative for intraepithelial lesion or malignancy (NILM) and atypical squamous cells of undetermined significance (ASC-US). In total, 128 Papanicolaou specimens comprising 41 ASC-US cases and 87 NILM cases were examined. Cell morphological analysis was performed using both area ratio (nuclear area in cells with nuclear enlargement/nuclear area in normal intermediate cells) and nuclear contour thickening. High-risk HPV was detected using the Uniplex E6/E7 polymerase chain reaction assay and logistic regression analyses of factors related to high-risk HPV infection were performed. Nuclear contour thickening was present in 57.7% (64/111 cells) of high-risk HPV positive cases and 21.8% (69/317 cells) of high-risk HPV negative cases. There was a statistically significant association (P=0.01) between high-risk HPV infection and nuclear contour thickening. Nuclear contour thickening was approximately one-third higher in NILM cases than in ASC-US cases (odds ratio, 0.371; 95% confidence interval, 0.208-0.662) and three times higher in high-risk HPV-positive cases than in high-risk HPV-negative cases (odds ratio, 2.831; 95% confidence interval, 1.591-5.039). Our results suggest that nuclear contour thickening in nuclear enlarged cells in NILM and ASC-US cases may be a cellular finding associated with HPV infection.