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首页> 外文期刊>Anticancer Research: International Journal of Cancer Research and Treatment >Spontaneous evolution of human papillomavirus infection in the uterine cervix.
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Spontaneous evolution of human papillomavirus infection in the uterine cervix.

机译：人宫颈乳头瘤病毒感染的自发进化。

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BACKGROUND: Little is known about the natural history and the malignant potential of low-grade cervical intraepithelial neoplasia associated with human papillomavirus (HPV) infection. Cervical cancer remains the second most frequent cause of death in women across the world. Epidemiologic and molecular studies have shown that human papillomavirus (HPV) is associated with cervical carcinogenesis. In this prospective study we examined the behavior of low-grade cervical intraepithelial lesions associated with HPV infection over a 6-year period. MATERIAL AND METHODS: During 1992, women with Papanicolaou smears reporting koilocytotic atypia (HPV effect) with or without grade 1 cervical intraepithelial neoplasia (HPV +/- CINI, low grade squamous intraepithelial lesions, LgSIL), along with colposcopic impression of LgSIL were included to the study. Between 1992 and 1998 all women underwent repeat Papanicolaou smears, colposcopic evaluation and HPV DNA testing every six months. HPV typing of cervical scrapes was done by PCR. RESULTS: A total of 330 women completed at least 6 years of follow up. Among women with high-risk HPV types (16/18), the presence of dysplasia (grade 1 cervical intraepithelial neoplasia) was significantly correlated with the progression of the lesion; 29% of cases with HPV + CINI (15 out of 75) progressed to more severe lesions versus only 9% of cases with HPV infection (18 out of 225), P < 0.001, chi-square test. The incidence of histologically confirmed progressive lesions was significantly greater in women with mild dysplasia (18 out of 75, 24%) compared to women without dysplasia (13 out of 255, 5%), P < 0.001, chi-square test. CONCLUSIONS: In our study HPV typing was not predictive of the evolution of low-grade intraepithelial lesions associated with HPV infection. Standard cytologic screening and colposcopy are the most effective means of monitoring low-grade lesions.
机译：背景：关于人类乳头瘤病毒（HPV）感染相关的低度宫颈上皮内瘤样变的自然史和恶性潜能知之甚少。宫颈癌仍然是全世界女性中第二常见的死亡原因。流行病学和分子研究表明，人乳头瘤病毒（HPV）与宫颈癌发生有关。在这项前瞻性研究中，我们研究了在6年内与HPV感染相关的低度宫颈上皮内病变的行为。材料与方法：在1992年，包括帕帕尼古拉涂片，报告有或没有1级宫颈上皮内瘤变（HPV +/- CINI，低度鳞状上皮内病变，LgSIL）以及阴道镜下观察到的小胶质细胞异型（HPV效应）的妇女去研究。在1992年至1998年之间，所有妇女每六个月进行一次巴氏涂片，阴道镜评估和HPV DNA检测。通过PCR完成宫颈刮伤的HPV分型。结果：共有330名妇女完成了至少6年的随访。在高危型HPV（16/18）的女性中，不典型增生（1级宫颈上皮内瘤变）的存在与病变的进展密切相关。 HPV + CINI的病例中有29％（75个中有15个）进展为更严重的病变，而HPV感染的病例中只有9％（225个中有18个）进展为更严重的病变，P <0.001，卡方检验。经组织学确认的进行性病变的发生率，与不典型增生的女性（75个中的13个，255个，5％）相比，轻度发育不良的女性（75个中的18个，24％），P <0.001，卡方检验。结论：在我们的研究中，HPV分型不能预测与HPV感染相关的低度上皮内病变的演变。标准的细胞学筛查和阴道镜检查是监测低度病变的最有效手段。

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