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The purpose of this work was to identify those nonclassic cytological signs that would allow the prediction of human papillomavirus (HPV) infection. Cytology samples taken from outpatients that attended public and private gynecological practices, between January of 2006 and December of 2008, were studied. The cytological samples were informed following the criteria of the Bethesda system 2001. Those reports with a cytological interpretation of low-grade squamous intraepithelial lesion/HPV (LSIL/HPV) were selected. Age data and other cytologic characteristics were also taken. 25,565 Pap smears were revised, of which 291 were LSIL/HPV. The age average of the patients was 32.01 years and the age range was between 15 and 67 years. 55.10% of the patients were below 30 years of age. The koilocytosis was the most frequent viral cytological sign (66.1%). Among the HPV infection associated nonclassic cytologic signs were in order of frequency: nuclear enlargement (44%), megalocytosis (38.5%), followed by binucleation and lightly irregular chromatin distribution, in the same proportion (33.7%) and the typical parakeratotic cells (33.3%). Discreet nuclear hyperchromasia and hiper-keratotic cells were the less frequent morphological changes (28.5%). The indirect signs significantly associated to the infection were: binucleation, lightly irregular chromatin distribution, discreet nuclear hyperchromasia and para-keratotic cells. The combination of HPV infection associated with nonclassic cytological signs would allow the identification of a high proportion of patients with this infection, increasing in this way the sensibility of the cytological study in the detection of HPV and the possibility of selecting subgroups at risk for the development of cervical lesions and their opportune study. |
