Incident Cervical HPV Infections in Young Women: Transition Probabilities for CIN and Infection Clearance
Incident Cervical HPV Infections in Young Women: Transition Probabilities for CIN and Infection Clearance
复制标题
DOI：
10.1158/1055-9965.epi-10-0791
复制
发表时间：
2011-02-01
影响因子：
3.8
通讯作者：
Haupt, Richard M.
中科院分区：
文献类型：
--
作者：
Insinga, Ralph P.;Perez, Gonzalo;Haupt, Richard M.
背景：我们描述了人类乳头瘤病毒（HPV） 16/18/31/33/35/45/52/58/59感染和宫颈上皮内瘤变（CIN） 1病变的转移概率。方法：在一项HPV疫苗试验的安慰剂组中，年龄在16至23岁的女性每隔大约6个月接受HPV细胞学和宫颈拭子PCR检测，时间长达4年。估计HPV感染与诊断CIN、清除（感染未检测到）或持续无CIN的累积比例。结果：大多数事件感染清除，未检测到CIN，从HPV31的66.9%到HPV59的91.1%不等。HPV16、18和31型感染后相关HPV型CIN1病变阳性的36个月发生率变化不大（范围16.7%-18.6%），HPV59和HPV33的风险较低（6.4%）和HPV33（2.9%）。CIN2的36个月转移概率从2.2%到9.1%不等；然而，对于该终点或CIN3，事件的数量通常太小，无法在不同类型中看到统计学上的显著差异。结论：某些HPV类型比其他类型更容易导致CIN1的诊断。在流行的CIN2/3中，HPV16相对于其他一些高危HPV类型（如HPV33）的相对优势，似乎与人群中HPV16感染事件的相对较高频率更直接相关，而不是感染进展到CIN2/3的较高风险。影响：几乎所有的HPV感染要么表现为可检测到的CIN，要么在36个月内无法检测到。一些HPV类型（例如16型和33型）似乎具有相似的CIN2/3风险，尽管发病率差异很大。癌症流行病学生物标志物；20 (2);287 - 96。AACR (C) 2011。
Background: We describe transition probabilities for incident human papillomavirus (HPV) 16/18/31/33/35/45/52/58/59 infections and cervical intraepithelial neoplasia (CIN) 1 lesions.Methods: Women ages 16 to 23 years underwent cytology and cervical swab PCR testing for HPV at approximately 6-month intervals for up to 4 years in the placebo arm of an HPV vaccine trial. The cumulative proportion of incident HPV infections with diagnosed CIN, clearing (infection undetectable), or persisting without CIN, were estimated.Results: Most incident infections cleared, without detection of CIN, ranging at 36 months from 66.9% for HPV31 to 91.1% for HPV59. There was little variation in the 36-month proportion of incident HPV16, 18, and 31 infections followed by a CIN1 lesion positive for the relevant HPV type (range 16.7%-18.6%), with lower risks for HPV59 (6.4%) and HPV33 (2.9%). Thirty-six-month transition probabilities for CIN2 ranged across types from 2.2% to 9.1%; however, the number of events was generally too small for statistically significant differences to be seen across types for this endpoint, or CIN3.Conclusions: Some incident HPV types appear more likely to result in diagnosed CIN1 than others. The relative predominance of HPV16, vis-a-vis some other high-risk HPV types (e. g., HPV33) in prevalent CIN2/3, appears more directly associated with relatively greater frequency of incident HPV16 infections within the population, than a higher risk of infection progression to CIN2/3.Impact: Nearly all incident HPV infections either manifest as detectable CIN or become undetectable within 36 months. Some HPV types (e. g., 16 and 33) appear to have similar risk of CIN2/3 despite widely varied incidence. Cancer Epidemiol Biomarkers Prev; 20(2); 287-96. (C)2011 AACR.