Utility of Human Papillomavirus Genotyping in the Management of Low-Grade Squamous Intraepithelial Lesions
Autor: | Francesc Alameda, Ester Miralpeix, Gemma Mancebo, Ramon Carreras, Beatriz Bellosillo, Josep M. Solé-Sedeno, Belen Lloveras |
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Rok vydání: | 2018 |
Předmět: |
Adult
Oncology medicine.medical_specialty Adolescent Genotyping Techniques Low-Grade Squamous Intraepithelial Lesions Young Adult 03 medical and health sciences 0302 clinical medicine Cervical intraepithelial neoplasia grade 2 Internal medicine Humans Medicine Human papillomavirus Young adult Papillomaviridae Genotyping Colposcopy 030219 obstetrics & reproductive medicine medicine.diagnostic_test business.industry Papillomavirus Infections Absolute risk reduction Disease Management virus diseases Obstetrics and Gynecology General Medicine Middle Aged female genital diseases and pregnancy complications 030220 oncology & carcinogenesis Relative risk Disease Progression Female Squamous Intraepithelial Lesions of the Cervix business Follow-Up Studies |
Zdroj: | Journal of Lower Genital Tract Disease. 22:13-16 |
ISSN: | 1526-0976 1089-2591 |
Popis: | Objective The aim of the study was to determine the usefulness of human papillomavirus (HPV) partial genotyping test in the triage of newly diagnosed low-grade squamous intraepithelial lesions (LSILs). Materials and methods We analyzed 143 patients with LSIL diagnosed de novo. Lesions were classified as positive for HPV 16 or HPV 18, positive for HPV but not HPV 16 or HPV 18 (HPVno16no18) or no HPV detected (HPVneg). Patients were followed for a period of 2 years or until the lesion progressed. We calculated absolute and relative risks for progression and regression according to the HPV result. Results The mean (SD) age was 33.8 (11.1) years. A total of 19.6% were positive for HPV 16, 4.9% for HPV 18, and 63.6% for HPVno16no18. The absolute risk of HPV 16 for progression to cervical intraepithelial neoplasia grade 2 or more (CIN 2+) was 32.1%, 14.3% for HPV 18, and 5.8% for HPVno16no18. None of the HPVneg cases evolved to CIN 2+. The presence of HPV 16 conferred a 7.4 (95% CI = 2.7-20.3) times greater risk of developing CIN 2+ than its absence. The absolute risks for HPV 16, HPV 18, HPVno16no18, and HPVneg for regression were 53.6%, 57.1%, 75.4%, and 87.5%, respectively. Relative risks for regression were 0.7 (95% CI = 0.5-0.9) for HPV 16 and 1.3 (95% CI = 1.1-1.5) for HPVneg. Conclusions The HPV 16 LSILs are more likely to progress to CIN 2+, so tight control and immediate colposcopy are crucial, whereas when HPV 16 is not present, follow-up could be less strict. Low-grade squamous intraepithelial lesions in which high-risk HPV is not detected do not progress to CIN 2+, so its control should be different from other LSIL, and conservative management could be an acceptable strategy. |
Databáze: | OpenAIRE |
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