Use of combining in situ hybridization and immunohistochemistry in detecting human papillomavirus on routine sections in cases of diagnostic uncertainty

To determine the combined role of in situ hybridization (ISH) and immunohistochemistry (IHC) in the detection of human papilloma virus (HPV) infection in cases of diagnostic uncertainty.A retrospective study.Department of Histopathology at the University of Zimbabwe and Department of Pathology at the University of Texas Medical Branch at Galveston in Texas, both teaching referral hospitals.23 patients with a diagnosis suggestive but not diagnostic of HPV infection on routine histology sections of uterine cervical biopsies, in which 20 had enough material to complete the study.Surgical pathology records of cases with morphologic features suggestive but not diagnostic of HPV cases were identified. Representative sections of each case were investigated with ISH and IHC for HPV infection.HPV DNA was detected in 12 cases. The bovine papilloma virus (BPV) antibody immunoreacted with six of the cases and two of these had not been detected by ISH resulting in a combined ISH and IHC, HPV detection of 14 cases.This preliminary data seems to support the validity of combining IHC and ISH, even though IHC is less sensitive compared to ISH, it may detect certain HPV types not represented in the DNA probe.