Rate of and risks for regression of cervical intraepithelial neoplasia 2 in adolescents and young women.
Rate of and risks for regression of cervical intraepithelial neoplasia 2 in adolescents and young women.
复制标题
DOI：
10.1097/aog.0b013e3181fe777f
复制
发表时间：
2010-12
影响因子：
7.2
通讯作者：
Shiboski S
中科院分区：
文献类型：
--
作者：
Moscicki AB;Ma Y;Wibbelsman C;Darragh TM;Powers A;Farhat S;Shiboski S
在一项年轻女性的前瞻性研究中描述CIN-2的自然史，并检查与消退和进展相关的行为和生物学因素。年龄在13至24岁的妇女被称为异常细胞学，并发现有CIN-2的组织学随访，在4个月的时间间隔。使用考克斯比例风险回归模型估计回归风险（定义为连续3次细胞学和组织学访视阴性）和进展至CIN-3。95名平均年龄为20.4岁（± 2.3岁）的女性进入分析。38%在第1年清除，63%在第2年清除，68%在第3年清除。多变量分析发现，最近N.淋病感染（H.R.）= 25.27 [95% C.I. 3.11，205.42]）和醋酸甲羟孕酮使用（每月）（H.R. = 1.02 [95% C.I. 1.003，1.04]）与回归相关。与非回归相关的因素包括联合激素避孕药的使用（每月）（H.R. = 0.85 [95% C.I. 0.75，0.97]）和任何类型的HPV的持续性（H.R. = 0.40 [95% C.I. 0.22，0.72]）。15%的女性在第3年出现进展。HPV 16/18持久性（H.R. = 25.27 [95% C.I.2.65，241.2，p = 0.005]）和末次访视时HPV 16/18状态（H.R. = 7.25 [95% C.I. 1.07，49.36）; p < 0.05]）与进展相关。由于样本量小，未检查其他协变量。CIN-2的高消退率支持在年轻女性中对该病变的临床观察。
To describe the natural history of CIN-2 in a prospective study of young women and to examine the behavioral and biologic factors associated with regression and progression. Women aged 13 to 24 years referred for abnormal cytology and were found to have CIN-2 on histology were followed at 4-month intervals. Risks for regression defined as 3 consecutive negative cytology and histology visits and progression to CIN-3 were estimated using Cox proportional hazards regression models. Ninety-five women with a mean age of 20.4 years (± 2.3) were entered into the analysis. Thirty-eight percent cleared by year 1, 63% by year 2 and 68% by year 3. Multivariable analysis found that recent N. gonorrhoeae infection (H.R. = 25.27 [95% C.I. 3.11, 205.42]) and medroxyprogesterone acetate use (per month) (H.R. = 1.02 [95% C.I. 1.003, 1.04]) were associated with regression. Factors associated with non-regression included combined hormonal contraception use (per month) (H.R. = 0.85 [95% C.I. 0.75, 0.97]) and persistence of HPV of any type (H.R. = 0.40 [95% C.I. 0.22, 0.72]). Fifteen percent of women showed progression by year 3. HPV 16/18 persistence (H.R. = 25.27 [95% C.I.2.65, 241.2, p = 0.005]) and HPV 16/18 status at last visit (H.R. = 7.25 [95% C.I. 1.07, 49.36); p < 0.05]) was associated with progression Because of the small sample size, other co-variates were not examined. The high regression rate of CIN-2 supports clinical observation of this lesion in young women.