Low risk of type-specific carcinogenic HPV re-appearance with subsequent cervical intraepithelial neoplasia grade 2/3.
Low risk of type-specific carcinogenic HPV re-appearance with subsequent cervical intraepithelial neoplasia grade 2/3.
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DOI：
10.1002/ijc.27418
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发表时间：
2012-10-15
影响因子：
6.4
通讯作者：
Burk, Robert D.
中科院分区：
文献类型：
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作者：
Cecilia Rodriguez, Ana;Schiffman, Mark;Herrero, Rolando;Hildesheim, Allan;Bratti, Concepcion;Sherman, Mark E.;Solomon, Diane;Guillen, Diego;Alfaro, Mario;Morales, Jorge;Hutchinson, Martha;Cheung, Li;Wacholder, Sholom;Burk, Robert D.
致癌的人类乳头瘤病毒(HPV)感染在首次性行为后非常常见，几乎所有的感染都在几年内变得无法检测(“清除”)。在清除后，特定类型的HPV再次出现的长期风险以及随后发生宫颈上皮内瘤变2级或更差(CIN2+)的风险尚未明确。在哥斯达黎加瓜纳卡斯特进行的这项为期7年的基于人群的队列研究中，我们研究了特定类型的致癌HPV感染在清除后再次出现的频率，以及再次出现导致CIN2+的频率。我们对2805名女性(年龄18-91岁，中位数34岁)进行了6个月或12个月的积极跟踪调查，通过MY09/11聚合酶链式反应检测到1740例致癌HPV感染。我们确定了患有一种或多种类型特异性HPV感染的女性，这些感染被清除并重新出现，并进一步定义了一个亚组，即“明确清除和再次出现”(≥2在≥1年期间干预阴性结果)。我们在不同的人群中确定了CIN2+的绝对风险。P值是双面的。只有7.7%(81/1052)的HPV感染妇女的干预结果为阴性。极少数(3.7%，39/1052)有“明确的清除和再次出现”，其中5.1%(2/39)后来坚持诊断为CIN2。无CIN3+病变。极少数女性(我们队列中2/2805的女性)有明确的类型特异性致癌HPV感染，并再次出现并导致CIN2+。如果得到证实，这就反对接种疫苗以避免再次出现导致前驱病变的情况，并反对在初步结果为阴性后进行频繁的HPV筛查。
Carcinogenic human papillomavirus (HPV) infections are very common after sexual debut and nearly all become undetectable (“clear”) within a few years. Following clearance, the long-term risks of type-specific HPV re-appearance and subsequent risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) are not well defined. In the 7-year, population-based cohort study in Guanacaste, Costa Rica, we studied how often type-specific carcinogenic HPV infections re-appeared after clearance, and how often re-appearance led to CIN2+. We considered 1740 carcinogenic HPV infections detected by MY09/11 PCR among 2805 women (18-91 years old, median 34) who were actively followed at 6- or 12-month intervals. We identified women with 1 or more type-specific HPV infections that cleared and re-appeared, and further defined a subgroup of “definite clearance and re-appearance” (≥ 2 intervening negative results over a period of ≥ 1 year). We determined the absolute risk of CIN2+ among the different groups. P values are two sided. Only 7.7% (81/1052) of HPV-infected women had intervening negative results. Very few (3.7%, 39/1052) had “definite clearance and re-appearance”, of which 5.1% (2/39) subsequently persisted to a diagnosis of CIN2. There were zero CIN3+ lesions. Extremely few women (2/2805 of women in our cohort) had a type-specific carcinogenic HPV infection clear, re-appear and lead to CIN2+. If confirmed, this argues against vaccination to avoid re-appearance that leads to precursor lesions and against the need of frequent HPV screening after initial negative results.
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影响因子：
11.2
作者：
Goodman MT;Shvetsov YB;McDuffie K;Wilkens LR;Zhu X;Thompson PJ;Ning L;Killeen J;Kamemoto L;Hernandez BY
通讯作者：
Hernandez BY
影响因子：
51.1
作者：
Cogliano, V;Baan, R;El Ghissassi, F
通讯作者：
El Ghissassi, F
DOI：
10.1158/1055-9965.epi-10-1108
发表时间：
2011-04
期刊：
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
影响因子：
--
作者：
Winer RL;Hughes JP;Feng Q;Xi LF;Cherne S;O'Reilly S;Kiviat NB;Koutsky LA
通讯作者：
Koutsky LA
影响因子：
120.7
作者：
Moscicki, AB;Hills, N;Palefsky, J
通讯作者：
Palefsky, J
影响因子：
6.4
作者：
Plummer, Martyn;Schiffman, Mark;Wheeler, Cosette M.
通讯作者：
Wheeler, Cosette M.