Guarisi Renata, Sarian Luis Otavio, Hammes Luciano Serpa, Longatto-Filho Adhemar, Derchain Sophie F M, Roteli-Martins Cecília, Naud Paulo, Erzen Mojca, Branca Margherita, Tatti Sílvio, Costa Silvano, Syrjänen Stina, Bragança Joana F, Syrjänen Kari
University of Campinas, UNICAMP, Campinas, SP, Brazil.
Acta Obstet Gynecol Scand. 2009;88(5):514-20. doi: 10.1080/00016340902846072.
To examine the effect of smoking on the incidence of low- and high-grade cervical intraepithelial neoplasia (CIN) in women with a baseline Pap smear of atypical squamous cells (ASC) or a low-grade squamous intraepithelial lesion (LSIL).
Prospective study in which a cohort of women with normal colposcopy and ASC/LSIL at baseline were followed at 6-month intervals of up to 36 months. Women were grouped in post-hoc analysis according to their smoking behavior: never (or past) smokers and current smokers.
This report was based on data from the Latin American Screening Study, conducted in Sao Paulo, Campinas, Porto Alegre (Brazil) and Buenos Aires (Argentina).
A subset of 150 women derived from a cohort of 1,011 women.
Multivariate Cox analysis and Kaplan-Meier curves were used.
Low- and high-grade CIN during follow-up.
The only factor related to an increased risk of developing CIN was the positive high-risk (hr) HPV status (hazard ratio (HR) = 3.42; 95% CI: 1.11-9.43). A total of 21 cases of incident CIN were detected during follow-up. Of these, 11 appeared in the group of 67 smokers and 10 among the 83 non-smoker women (log-rank, p=0.33). Smoking status was not associated with the risk of developing CIN (HR = 0.73; 95% CI: 0.40-1.33). However, when restricting the analysis to high-grade CIN only (11 cases), the probability of developing the disease was significantly higher among smokers (p=0.04).
Smoking contributes additional risk for developing high-grade CIN in women with ASC or LSIL cytology but normal colposcopy.
研究吸烟对基线巴氏涂片显示非典型鳞状细胞（ASC）或低度鳞状上皮内病变（LSIL）的女性发生低度和高度宫颈上皮内瘤变（CIN）的影响。
前瞻性研究，对一组基线阴道镜检查正常且为ASC/LSIL的女性进行为期36个月、每6个月一次的随访。在事后分析中，根据吸烟行为将女性分为：从不（或过去）吸烟者和当前吸烟者。
本报告基于拉丁美洲筛查研究的数据，该研究在巴西圣保罗、坎皮纳斯、阿雷格里港以及阿根廷布宜诺斯艾利斯开展。
从1011名女性队列中选取的150名女性子集。
采用多变量Cox分析和Kaplan-Meier曲线。
随访期间的低度和高度CIN。
与CIN发生风险增加相关的唯一因素是高危（hr）人乳头瘤病毒（HPV）状态阳性（风险比（HR）=3.42；95%置信区间：1.11 - 9.43）。随访期间共检测到21例新发CIN病例。其中，67名吸烟者中有11例，83名非吸烟女性中有10例（对数秩检验，p = 0.33）。吸烟状态与CIN发生风险无关（HR = 0.73；95%置信区间：0.40 - 1.33）。然而，仅将分析限制在高度CIN（11例）时，吸烟者患该病的概率显著更高（p = 0.04）。
吸烟会增加ASC或LSIL细胞学检查但阴道镜检查正常的女性发生高度CIN的额外风险。
