Potential impact of combined high- and low-risk human papillomavirus infection on the progression of cervical intraepithelial neoplasia 2
Potential impact of combined high- and low-risk human papillomavirus infection on the progression of cervical intraepithelial neoplasia 2
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高危和低危人乳头瘤病毒联合感染对宫颈上皮内瘤变进展的潜在影响2
DOI：
10.1111/jog.12202
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发表时间：
2014
期刊：
影响因子：
--
通讯作者：
Takizawa K
中科院分区：
文献类型：
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作者：
Okadome M;Saito T;Tanaka H;Nogawa T;Furuta R;Watanabe K;Kita T;Yamamoto K;Mikami M;Takizawa K
目的少数研究探讨了低危型人乳头瘤病毒（LR-HPV）和高危型人乳头瘤病毒（HR-HPV）联合感染对宫颈上皮内瘤变（CIN）2至CIN 3进展的影响。这项多机构前瞻性队列研究调查了各种组合的HR-HPV和LR-HPV infection.MethodsBetween 2007年1月和2008年5月，122名妇女与CIN 2（年龄20-50岁）从日本各地的24家医院的进展的风险。在2年随访后，对93名女性进行了细胞学、阴道镜检查、HR-HPV检测和HPV基因分型分析。阴道镜导向活检在进入和本研究结束时进行，或当疾病进展是suspiced.ResultsAmong 93名妇女与CIN 2，87（93.5%）有HR-HPV感染。其中24例（27.6%）进展为CIN 3，49例（56.3%）消退。没有HR-HPV感染的6名CIN 2女性中没有进展。HR-HPV和LR-HPV联合感染的女性（3/28，10.7%）的进展率显著低于仅HR-HPV感染的女性（21/59，35.6%;P= 0.016）。多变量分析显示，HR-HPV感染女性的CIN 2进展与LR-HPV合并感染呈负相关（风险比= 0.152; 95%置信区间[CI] = 0.042-0.553）。CIN 2消退与LR-HPV合并感染呈正相关（OR = 4.553; 95%CI = 1.378-15.039）。这一发现可能对诊断为CIN 2的妇女的管理有用。
AimFew studies have examined the effect of combined low‐risk human papillomavirus (LR‐HPV) and high‐risk human papillomavirus (HR‐HPV) infection on the progression of cervical intraepithelial neoplasia (CIN)2 to CIN3. This multi‐institutional prospective cohort study investigated the risk of progression of CIN2 with various combinations of HR‐HPV and LR‐HPV infection.MethodsBetween January 2007 and May 2008, 122 women with CIN2 (aged 20–50 years) from 24 hospitals throughout Japan were enrolled in the study. Ninety‐three women were analyzed after a 2‐year follow‐up with cytology, colposcopy, HR‐HPV testing and HPV genotyping. Colposcopy‐directed biopsy was performed at entry and the end of this study, or when disease progression was suspected.ResultsAmong 93 women with CIN2, 87 (93.5%) had HR‐HPV infection. Among these 87 cases, 24 (27.6%) progressed to CIN3 and 49 (56.3%) regressed. None of the six women with CIN2 without HR‐HPV infection progressed. The progression rate was significantly lower in women with combined HR‐HPV and LR‐HPV infection (3/28, 10.7%) than in those with HR‐HPV infection only (21/59, 35.6%;P= 0.016). Multivariate analyses showed that CIN2 progression in women with HR‐HPV infection was negatively associated with LR‐HPV co‐infection (hazard ratio = 0.152; 95% confidence interval [CI] = 0.042–0.553). CIN2 regression was positively associated with LR‐HPV co‐infection (odds ratio = 4.553; 95% CI = 1.378–15.039).ConclusionThe risk of CIN2 progression is low in women with combined infection of HR‐HPV and LR‐HPV. The finding may be useful for management of women diagnosed with CIN2.