Role of Chlamydia trachomatis serology in conservative management of cervical intraepithelial neoplasia grade 2
| Autor: | Silvia Agramunt, Belen Lloveras, Ester Miralpeix, Ramon Gimeno, Gemma Mancebo, Ramon Carreras, JM Sole-Sedeno, Francesc Alameda |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
medicine.medical_specialty Uterine Cervical Neoplasms Chlamydia trachomatis Conservative Treatment medicine.disease_cause Cervical intraepithelial neoplasia Serology 03 medical and health sciences 0302 clinical medicine Internal medicine Cytology Humans Medicine Prospective Studies 030212 general & internal medicine 030219 obstetrics & reproductive medicine Chlamydia business.industry Papillomavirus Infections Obstetrics and Gynecology General Medicine Odds ratio Chlamydia Infections Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Confidence interval Squamous intraepithelial lesion Immunoglobulin G Disease Progression Female business |
| Zdroj: | International Journal of Gynecology & Obstetrics. 147:43-48 |
| ISSN: | 1879-3479 0020-7292 |
| Popis: | Objective To evaluate the spontaneous progression of cervical intraepithelial neoplasia grade 2 (CIN2) in accordance with Chlamydia trachomatis (chlamydia) serology. Methods A prospective observational study included women diagnosed with CIN2 by cervical biopsy and managed conservatively for 24 months at Hospital del Mar, Barcelona, between December 2011 and October 2013. Serum anti-chlamydia immunoglobulin G (IgG), previous cytology, and high-risk human papillomavirus (HPV) genotyping were recorded at baseline. The outcome was regression, persistence, or progression of CIN2. Results Overall, 93 women aged 18-56 years were enrolled. Spontaneous regression was observed for 61 (66%) women, and 21 (23%) progressed to CIN3. Eight (9%) women had chlamydia seropositivity at baseline. Multivariate analysis showed that anti-chlamydia IgG seropositivity (odds ratio [OR], 19.1; 95% confidence interval [CI], 1.9-189.7), previous high-grade squamous intraepithelial lesion cytology (OR, 5.0; 95% CI, 1.7-14.6), and HPV16 (OR, 4.8; 95% CI, 1.7-13.7) increased the risk of CIN2 persistence or progression. Conclusion Women with CIN2 and chlamydia IgG seropositivity had increased risk of progression to CIN2+ and immediate treatment may be recommended for these women. Larger clinical studies are needed to confirm the results, but chlamydia serology might be introduced into CIN2 management to better individualize treatment. |
| Databáze: | OpenAIRE |
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