An association of cervical inflammation with high-grade cervical neoplasia in women infected with oncogenic human papillomavirus (HPV)
| Autor: | P E, Castle, S L, Hillier, L K, Rabe, A, Hildesheim, R, Herrero, M C, Bratti, M E, Sherman, R D, Burk, A C, Rodriguez, M, Alfaro, M L, Hutchinson, J, Morales, M, Schiffman |
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| Rok vydání: | 2001 |
| Předmět: |
Adult
Incidence Papillomavirus Infections Uterine Cervical Neoplasms Comorbidity Middle Aged Risk Assessment Severity of Illness Index Sampling Studies Uterine Cervicitis Cohort Studies Tumor Virus Infections Age Distribution Reference Values Case-Control Studies Confidence Intervals Odds Ratio Humans Female DNA Probes HPV Probability |
| Zdroj: | Cancer epidemiology, biomarkersprevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 10(10) |
| ISSN: | 1055-9965 |
| Popis: | Previous reports of genital conditions, such as nonspecific genital infection/sore or vaginal discharge associated with cervical cancer (L. A. Brinton et al., J. Natl. Cancer Inst. (Bethesda), 79: 23-30, 1987; C. J. Jones et al., Cancer Res., 50: 3657-3662, 1990), suggest a possible link between either genital tract inflammation or changes in bacteria flora consistent with bacterial vaginosis (BV) and cervical cancer. To test whether changes in vaginal bacterial flora or the degree of cervical inflammation are associated with women having a human papillomavirus (HPV) infection or with women infected with oncogenic HPV having high-grade cervical lesions (high-grade squamous intraepithelial lesions or cancer), we conducted a case-control study of women50 years old enrolled in the Costa Rican natural history study of HPV and cervical neoplasia. To test whether BV and inflammation were associated with HPV DNA positivity, Analysis 1 was restricted to women with no or mild (low-grade or equivocal) cytological abnormalities, and the degree of inflammation and Nugent score (a measure of BV) were compared between women infected (n = 220) and not infected (n = 130) with HPV. To test whether BV and inflammation were associated with high-grade lesions, Analysis 2 was restricted to women infected with oncogenic HPV, and the degree of inflammation and Nugent score were compared between women with (n = 95) and without (n = 158) high-grade cervical lesions. In Analysis 1, BV and cervical inflammation were not associated with HPV infection. In Analysis 2, BV was not associated with high-grade lesions. However, we found a marginally significant positive trend of increasing cervical inflammation associated with high-grade lesions in oncogenic HPV-infected women, (P(trend) = 0.05). Overt cervicitis was associated with a 1.9-fold increase in risk of high-grade lesions (95% confidence interval, 0.90-4.1). The results of this study suggest that cervical inflammation may be associated with high-grade lesions and may be a cofactor for high-grade cervical lesions in women infected with oncogenic HPV. |
| Databáze: | OpenAIRE |
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