Risk Factors for Persistent Cervical Intraepithelial Neoplasia Grades 1 and 2
| Autor: | Robert D. Burk, Maria Abadi, Shelly Trim, Seymour L. Romney, Prabhudas R. Palan, Magdy Mikhail, Gloria Y.F. Ho, Mark H. Einstein, Benjamin Thysen, Anna S. Kadish, Nafisseh Soroudi, Jayasri Basu, Laura Reimers |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
medicine.medical_specialty Biopsy viruses medicine.medical_treatment MEDLINE Ascorbic Acid urologic and male genital diseases Cervical intraepithelial neoplasia Severity of Illness Index Article Folic Acid Risk Factors Internal medicine Severity of illness medicine Humans Papillomaviridae Human papillomavirus Watchful Waiting neoplasms Gynecology medicine.diagnostic_test biology business.industry Papillomavirus Infections virus diseases Obstetrics and Gynecology General Medicine Uterine Cervical Dysplasia biology.organism_classification Ascorbic acid medicine.disease female genital diseases and pregnancy complications Female business Watchful waiting |
| Zdroj: | Journal of Lower Genital Tract Disease. 15:268-275 |
| ISSN: | 1089-2591 |
| DOI: | 10.1097/lgt.0b013e3182216fef |
| Popis: | This study examines risk factors for persistent cervical intraepithelial neoplasia (CIN) and examines whether human papillomavirus (HPV) testing predicts persistent lesions.: Women with histologically diagnosed CIN 1 or CIN 2 (n = 206) were followed up every 3 months without treatment. Human papillomavirus genotyping, plasma levels of ascorbic acid, and red blood cell folate levels were obtained. Cervical biopsy at 12 months determined the presence of CIN. Relative risk (RR) was estimated by log-linked binomial regression models.: At 12 months, 70% of CIN 1 versus 54% of CIN 2 lesions spontaneously regressed (p.001). Levels of folate or ascorbic acid were not associated with persistent CIN at 12 months. Compared with HPV-negative women, those with multiple HPV types (RRs ranged from 1.68 to 2.17 at each follow-up visit) or high-risk types (RRs range = 1.74-2.09) were at increased risk for persistent CIN; women with HPV-16/18 had the highest risk (RRs range = 1.91-2.21). Persistent infection with a high-risk type was also associated with persistent CIN (RRs range = 1.50-2.35). Typing for high-risk HPVs at 6 months only had a sensitivity of 46% in predicting persistence of any lesions at 12 months.: Spontaneous regression of CIN 1 and 2 occurs frequently within 12 months. Human papillomavirus infection is the major risk factor for persistent CIN. However, HPV testing cannot reliably predict persistence of any lesion. |
| Databáze: | OpenAIRE |
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