High-risk HPV-positive and -negative high-grade cervical dysplasia: Analysis of 5-year outcomes
| Autor: | Giovanni Scambia, Mario Malzoni, Lavinia Mosca, Lorenzo Aguzzoli, Nicola Colacurci, Gabriele Carlinfante, Marco Petrillo, Stefano Greggi, Paolo Vercellini, Antonio Cianci, Francesco Raspagliesi, Andrea Giannini, Andrea Ciavattini, Viola Liberale, Sara Bosio, Luca Giannella, Maurizio Serati, Rocco Guerrisi, Simone Ferrero, Michele Desiato, Pierandrea De Iaco, Anna Myriam Perrone, Giorgio Bogani, Fabio Ghezzi, Biagio Contino, Francesca Falcone, Arsenio Spinillo, Francesco Sopracordevole, Claudia Brusadelli, Antonio Simone Laganà, Simona Ruisi, Maria Grazia Matarazzo, Pierluigi Benedetti Panici, Paola Carunchio, Giuseppe Sarpietro, Alessandro Ghelardi, Barbara Gardella, Francesco Plotti, Alice Bergamini, Margherita Fischetti, Antonino Ditto, Gian Franco Zannoni, Gabriella Ferrandina, Vincenzo Dario Mandato, Valentina Chiappa, Violante Di Donato, Raffaele Tinelli, Ermelinda Monti, Roberto Angioli, Salvatore Dessole, Annunziata Carlea, Ciro Pinelli, Fulvio Zullo, Salvatore Lopez, Sara Lovati, Tommaso Simoncini, Maria Giovanna Salerno, Mauro Signorelli, Rosa De Vincenzo, Cono Scaffa, Jvan Casarin, Chiara Borghi, Cristina Donfrancesco, Ludovico Muzii, Giovanni D'ippolito, Gaetano Valenti, Andrea Dell'Acqua, Giulia Dondi |
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| Přispěvatelé: | Bogani, G., Sopracordevole, F., Di Donato, V., Ciavattini, A., Ghelardi, A., Lopez, S., Simoncini, T., Plotti, F., Casarin, J., Serati, M., Pinelli, C., Valenti, G., Bergamini, A., Gardella, B., Dell'Acqua, A., Monti, E., Vercellini, P., Fischetti, M., D'Ippolito, G., Aguzzoli, L., Mandato, V. D., Carunchio, P., Carlinfante, G., Giannella, L., Scaffa, C., Falcone, F., Borghi, C., Ditto, A., Malzoni, M., Giannini, A., Salerno, M. G., Liberale, V., Contino, B., Donfrancesco, C., Desiato, M., Perrone, A. M., Dondi, G., De Iaco, P., Chiappa, V., Ferrero, S., Sarpietro, G., Matarazzo, M. G., Cianci, A., Bosio, S., Ruisi, S., Guerrisi, R., Brusadelli, C., Mosca, L., Lagana', A. S., Tinelli, R., Signorelli, M., De Vincenzo, R., Zannoni, G. F., Ferrandina, G., Lovati, S., Petrillo, M., Dessole, S., Carlea, A., Zullo, F., Angioli, R., Greggi, S., Spinillo, A., Ghezzi, F., Colacurci, N., Muzii, L., Benedetti Panici, P., Scambia, G., Raspagliesi, F., Bogani G., Sopracordevole F., Di Donato V., Ciavattini A., Ghelardi A., Lopez S., Simoncini T., Plotti F., Casarin J., Serati M., Pinelli C., Valenti G., Bergamini A., Gardella B., Dell'acqua A., Monti E., Vercellini P., Fischetti M., D'ippolito G., Aguzzoli L., Mandato V.D., Carunchio P., Carlinfante G., Giannella L., Scaffa C., Falcone F., Borghi C., Ditto A., Malzoni M., Giannini A., Salerno M.G., Liberale V., Contino B., Donfrancesco C., Desiato M., Perrone A.M., Dondi G., De Iaco P., Chiappa V., Ferrero S., Sarpietro G., Matarazzo M.G., Cianci A., Bosio S., Ruisi S., Guerrisi R., Brusadelli C., Mosca L., Lagana' A.S., Tinelli R., Signorelli M., De Vincenzo R., Zannoni G.F., Ferrandina G., Lovati S., Petrillo M., Dessole S., Carlea A., Zullo F., Angioli R., Greggi S., Spinillo A., Ghezzi F., Colacurci N., Muzii L., Benedetti Panici P., Scambia G., Raspagliesi F. |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
0301 basic medicine
Adult medicine.medical_specialty HPV Uterine Cervical Neoplasm Prognosi CIN conization negative positive Conization Uterine Cervical Neoplasms 03 medical and health sciences Young Adult 0302 clinical medicine Risk Factors Retrospective Studie medicine Humans Cervical Intraepithelial Neoplasia Prospective cohort study Propensity Score Papillomavirus Infection Retrospective Studies Obstetrics Proportional hazards model business.industry Risk Factor Papillomavirus Infections Obstetrics and Gynecology Retrospective cohort study Middle Aged Prognosis medicine.disease Negative Uterine Cervical Dysplasia female genital diseases and pregnancy complications 030104 developmental biology Settore MED/40 - GINECOLOGIA E OSTETRICIA Oncology Dysplasia 030220 oncology & carcinogenesis Cohort Propensity score matching Population study Female business Positive Cohort study Human |
| Popis: | Objective: To evaluate the outcomes of high-risk (HR) HPV-positive and -negative women affected by high-grade cervical dysplasia. Methods: This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of confounding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results: Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and -negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multivariate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions: HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data. |
| Databáze: | OpenAIRE |
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