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High risk HPV DNA subtypes and E6/E7 mRNA expression in a cohort of colposcopy patients from Northern Italy with high-grade histologically verified cervical lesions.

To evaluate the prevalence of HPV DNA genotypes in women diagnosed with cervical intraepithelial neoplasia grade 2 or greater (CIN 2+), together with the detection of mRNA transcripts from HPV 16/18/31/33/45. In 1113 women referred to our colposcopy unit for abnormal cytology, colposcopic assessment was followed by histologic examination for final diagnosis and by presence of HPV DNA and E6/E7 mRNA transcripts. A total of 134 CIN 2+ cases were identified. Out of the 134 women with CIN 2+ cervical lesions, 115 cases (85.8%) tested positive by PCR to HR HPV DNA types, and 19 (14.2%) were HR HPV DNA negative. 68 cases (50.7%) were positive for HPV DNA 16/18/31/33/45 and of them 50 cases were E6/E7 positive, and 18 were E6/E7 negative. 47 cases (35.1%) were positive for high risk types other than 16/18/31/33/45. HPV 16 is the most frequent genotype found in histologically confirmed high grade cervical lesions in our series; HPV 31 is the second most frequent type, contributing significantly to the proportion of women with CIN 2+ lesions in our population and shows a higher prevalence than HPV 18. Out of the 979 women with lesions less than CIN 2, 588 cases tested positive by PCR to high risk HPV DNA types (60.1%), and 98 cases were E6/E7 positive from HPV 16/18/31/33/45 (10.1%). Although HPV DNA and mRNA negative results should be evaluated with caution, since they could represent "false negatives", high risk HPV DNA positivity should be assessed carefully with colposcopy before performing excisional treatments, particularly in adolescents but also in patients who want child, since they may reflect transient situations.