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首页> 外文期刊>Acta Obstetricia et Gynecologica Scandinavica: Official Publication of the Nordisk Forening for Obstetrik och Gynekologi >Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study.
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Human papillomavirus and predictors of cervical intraepithelial neoplasia among young mothers in a prospective follow-up study.

机译：在一项前瞻性随访研究中，人乳头瘤病毒和年轻母亲宫颈上皮内瘤变的预测因子。

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Objective. To study the incidence times and rates for cervical intraepithelial neoplasia (CIN) and its predictors. Material and methods. This is a prospective follow-up study at Turku University Hospital, Finland. The Finnish Family human papillomavirus (HPV) study comprised 329 pregnant women followed up for 3 years. In an extension of the follow-up period, 171 women participated in an additional 3 years follow-up. Cervical scrapings for HPV testing and cervical smears were collected at each follow-up visit (2, 12, 24 and 36 months and 6 years). Following two abnormal cervical smears, colposcopy with biopsies was done. The main outcome measures were actuarial and crude incidence times, incidence rates and predictors of incident CIN. Results. During the follow-up period, 10 women (3.2%) developed biopsy-confirmed CIN, and four presented with incident atypical squamous cells suggesting high-grade squamous intraepithelial lesion cytology. The CIN/squamous intraepithelial lesion developed in 74.5 and 66.3 months, with crude incidence rates of 13.4/1,000 and 15.1/1,000 women months at risk, respectively. In multivariate Poisson regression, independent predictors of incident CIN were as follows: high-risk HPV positive at baseline (incidence rate ratio = 5.54; 95% confidence interval 1.02-30.14, p= 0.048); type-specific high-risk HPV persistence during follow-up (incidence rate ratio = 5.84; 95% confidence interval 2.28-17.93, p= 0.0001); cervical smear cytologically diagnosed for atypical squamous cells of undetermined significance or worse at any follow-up visit (incidence rate ratio = 4.56; 95% confidence interval 2.37-8.78, p= 0.0001); and new sexual partner during follow-up (incidence rate ratio = 9.45; 95% confidence interval 1.90-46.97, p= 0.006). Conclusion. The results indicate that combined use of cervical smear and HPV testing, with prompt referral to colposcopy, enables accurate detection of incident CIN well before progression to invasive cancer. In addition to baseline and persistent high-risk HPV, abnormal cervical smear and new sexual partner are key predictors of incident CIN.
机译：目的。研究宫颈上皮内瘤变（CIN）的发生时间和发生率及其预测因素。材料与方法。这是在芬兰图尔库大学医院进行的一项前瞻性随访研究。芬兰家庭人类乳头瘤病毒（HPV）研究包括329名孕妇，随访了3年。在延长随访期间，有171名妇女参加了另外3年的随访。在每次随访中（2、12、24、36个月和6年）收集用于HPV检测的宫颈刮片和宫颈涂片。在两次宫颈涂片异常之后，进行了带活检的阴道镜检查。主要结局指标是精算和粗略的发生时间，发生率和事件CIN的预测指标。结果。在随访期间，有10名妇女（3.2％）进行了活组织检查证实的CIN，其中有4名出现了非典型鳞状细胞事件，提示其鳞状上皮内病变细胞学较高。 CIN /鳞状上皮内病变发生在74.5和66.3个月，处于危险阶段的妇女的粗发病率分别为13.4 / 1,000和15.1 / 1,000。在多元Poisson回归中，事件CIN的独立预测因素如下：基线时高风险HPV阳性（发生率比= 5.54; 95％置信区间1.02-30.14，p = 0.048）;随访期间特定类型的高危HPV持续性（发生率比= 5.84; 95％置信区间2.28-17.93，p = 0.0001）;经细胞学检查诊断为非典型鳞状细胞的宫颈涂片在任何后续随访中均具有未确定的意义或更严重（发生率比= 4.56; 95％置信区间2.37-8.78，p = 0.0001）;和随访期间的新性伴侣（发生率比= 9.45; 95％置信区间1.90-46.97，p = 0.006）。结论。结果表明，宫颈涂片检查和HPV检测的结合使用，以及及时转诊至阴道镜检查，可以在发展为浸润性癌症之前准确检测出CIN。除了基线和持续的高危HPV外，异常的宫颈涂片和新的性伴侣也是发生CIN的关键指标。

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