The natural history of CIN I lesions.
The natural history of CIN I lesions.
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DOI：
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发表时间：
1998
影响因子：
0.4
通讯作者：
M. Duggan;S. Mcgregor;G. Stuart;Scott J. Morris;V. Chang-Poon;A. Schepansky;L. Honore
中科院分区：
文献类型：
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作者：
M. Duggan;S. Mcgregor;G. Stuart;Scott J. Morris;V. Chang-Poon;A. Schepansky;L. Honore
已发表的文献表明，平均有11%的CIN I病变进展为更高级别的异型增生，其余病变退化或持续存在。疾病结果的可靠标志物尚未确定。一项对342名因宫颈上皮内瘤样病变I（CIN I）而接受阴道镜检查的妇女进行的纵向研究，通过筛查性巴氏试验检测到CIN I，并通过阴道镜印模和巴氏试验将该检查分类为</= CIN 1，旨在确定疾病结局的预测因素。该队列由220名妇女组成，她们满意地完成了研究，并且她们的疾病在初次检查时既没有进行活检也没有接受治疗。所有人都通过PCR进行了HPV DNA检测，并在有限的时间内进行了间隔阴道镜检查和重复巴氏试验。分析初始HPV DNA状态和一些测量的临床病理学和危险因素变量，以确定结果预测因子。所有患者在研究结束时或因为其疾病在随访期间被认为已经进展而接受了活检。活检证实41例（18.6%）进展为CIN II/III，41例（18.6%）持续为CIN I/湿疣，138例（62.7%）消退为<CIN I/湿疣。HPV DNA阳性和目前口服避孕药的使用是唯一的独立预测疾病进展的因素，诊断时的年龄，随访次数和疾病进展的时间都得到了控制。未确定疾病持续和消退的预测因素。该研究强调了HPV检测在CIN I病变阴道镜治疗中的临床作用。口服避孕药可通过调节HPV的致癌序列促进疾病进展。
The published literature indicates 11% of CIN I lesions on average progress to a higher grade dysplasia and the remainder either regress or persist. Reliable markers of disease outcome are yet to be identified. A longitudinal study of 342 women referred for colposcopic examination of a CIN I detected by a screening Pap test, and classified by the colposcopic impression and Pap test at that exam as </= CIN 1 was designed to identify predictors of disease outcome. The cohort was comprised of 220 women who satisfactorily completed the study and whose disease was neither biopsied or treated at the initial examination. All had HPV DNA testing by PCR, and were followed with interval colposcopic examinations and repeat Pap tests for a limited time period. The initial HPV DNA status and a number of measured clinico-pathological and risk factor variables were analyzed to identify outcome predictors. All underwent a biopsy either at the conclusion of the study or because their disease was considered to have progressed during the follow up period. Biopsy confirmed progression to CIN II/III occurred in 41 (18.6%), persistence of CIN I/Condyloma in 41 (18.6%), and regression to <CIN I/Condyloma in 138 (62.7%). HPV DNA positivity and current, oral contraceptive use were the only independent predictors of progression when age at diagnosis, the number of follow up visits, and time to progression were controlled. Predictors of persistent and regressed disease were not identified. The study highlights a clinical role for HPV testing in the colposcopic management of CIN I lesions. Oral contraceptives may promote progression by regulating the oncogenic sequences of the HPV.