High-risk human papillomavirus screening and testing with immunohistochemical surrogate biomarkers: an alternative to polymerase chain reaction

The vacuolisation and ballooning of cervical squamous cells, presently known as koilocytosis, was first described in 1957 by FW Stewart, who defined it as “warty atypia” (a hint towards a possible viral link). The presence of viral particles in the nuclei of epithelial cells of condylomata was first documented electron microscopically by AEG Dunn and NM Ogilvie in 1968. Similarities between condylomata and cervical precancerous lesions led to the hypothesis that the papovavirus causing condylomata may be a contributory factor in cervical carcinogenesis. This hypothesis was confirmed in 1978 by Laverty et al, with the electron microscopic identification of viral particles consistent with a papillomavirus, in a preinvasive lesion in an immunosuppressed woman.1