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Titolo:
PERSISTENT GENITAL HUMAN PAPILLOMAVIRUS INFECTION AS A RISK FACTOR FOR PERSISTENT CERVICAL DYSPLASIA
Autore:
HO GYF; BURK RD; KLEIN S; KADISH AS; CHANG CJ; PALAN P; BASU J; TACHEZY R; LEWIS R; ROMNEY S;
Indirizzi:
ALBERT EINSTEIN COLL MED,DEPT EPIDEMIOL & SOCIAL MED,1300 MORRIS PK AVE BRONX NY 10461 ALBERT EINSTEIN COLL MED,DEPT PEDIAT BRONX NY 10461 ALBERT EINSTEIN COLL MED,DEPT OBSTET & GYNECOL BRONX NY 10461 ALBERT EINSTEIN COLL MED,DEPT MICROBIOL & IMMUNOL BRONX NY 10461
Titolo Testata:
Journal of the National Cancer Institute
fascicolo: 18, volume: 87, anno: 1995,
pagine: 1365 - 1371
Fonte:
ISI
Lingua:
ENG
Soggetto:
LONGITUDINAL DATA-ANALYSIS; ORAL-CONTRACEPTIVE USE; TERM FOLLOW-UP; INTRAEPITHELIAL NEOPLASIA; BEHAVIOR; SMOKING;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
28
Recensione:
Indirizzi per estratti:
Citazione:
G.Y.F. Ho et al., "PERSISTENT GENITAL HUMAN PAPILLOMAVIRUS INFECTION AS A RISK FACTOR FOR PERSISTENT CERVICAL DYSPLASIA", Journal of the National Cancer Institute, 87(18), 1995, pp. 1365-1371

Abstract

Background: Cervical dysplasia, also referred to as squamous intraepithelial lesion (SIL) in cytology or cervical intraepithelial neoplasiain histopathology, is thought to have the potential to advance in progressive stages to cervical cancer. However, not all cases of SIL progress, and most of the mild lesions spontaneously regress. Factors thatgovern regression, persistence, and progression of SIL are poorly understood. Purpose: Our analysis sought to identify factors that determined persistence or regression of SIL. Methods: Seventy subjects with histopathologically confirmed cervical dysplasia were followed at 3-month intervals for 15 months. At each visit, the cervix was evaluated byPap smear and colposcopy, and exfoliated cervicovaginal cells were analyzed for human papillomavirus (HPV) DNA. For each subject, data fromevery two consecutive visits were grouped as a pair. Persistent SIL was considered present if a lesion was detected at a visit (t) as well as at the next visit (t + 1) and absent if a lesion was detected at visit t but not at visit t + 1. A statistical model for time-dependent data correlated persistent SIL with various risk factors. Results: Age,ethnicity, education, sexual behavior, smoking, and the use of oral contraceptives did not correlate with persistent SIL. The risk of persistent SIL was associated with continual HPV infection in visits t and t + 1 (HPV positive by Southern blot analysis: odds ratio [OR] = 3.91,and 95% confidence interval [CI] = 1.58-9.65; HPV positive by polymerase chain reaction [PCR]: OR = 2.42, and 95% CI = 1.03-5.67) and a persistent high viral load (OR = 4.07, and 95% CI = 1.35-12.30). When typed by PCR, individuals with type-specific persistent infection in visits t and t + 1, and particularly those with a continual high viral load (OR = 4.97; 95% CI = 1.45-17.02), had the highest risk for persistent SIL compared with those with a low level of type-specific persistentinfection or non-type-specific persistent infection. The presence of persistent HPV infection in visits t - 1 and t (the preceding time interval) was also predictive of persistent SIL in visits t and t + 1, although the strength of association was weaker, suggesting that persistent HPV and SIL occur synchronously. Conclusion: HPV infection and itsassociated cervical lesions tend to occur concurrently, and type-specific persistent HPV infection, particularly with a high viral load, produces chronic cervical dysplasia. Implications: The natural history of genital HPV infection directly influences the prognosis of cervical dysplasia as measured by persistence of the lesion. Testing for HPV infection may be valuable in the clinical management of women with cervical dysplasia.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/01/21 alle ore 08:04:20