Kim J W, Song S H, Jin C H, Lee J K, Lee N W, Lee K W
Department of Obstetrics and Gynaecology, Korea University Guro Hospital, Seoul, Republic of Korea.
J Int Med Res. 2012;40(2):486-96. doi: 10.1177/147323001204000210.
This study aimed to identify factors that predict clearance of high-risk human papillomavirus (HPV) infection and progression to cervical intraepithelial neoplasia (CIN) 2 or higher, in women with normal cervical histology or CIN 1.
A retrospective analysis was performed on 817 high-risk HPV-infected women with histologically verified CIN 1 or normal cervical histology. Patients were followed-up for a maximum of 24 months. Cervical HPV DNA tests were performed at every visit.
At the end of followup, 648/817 (79.3%) patients were free from HPV infection and 66/817 patients (8.1%) progressed to CIN 2 or higher. Age, parity, cytology and viral load at diagnosis were significantly and inversely associated with HPV clearance. Cytology, viral load and presence of CIN 1 lesions were significantly associated with lesion progression.
Cytology and high-risk HPV viral load may be useful markers for the likelihood of high-risk HPV clearance and lesion progression. Histological status, parity and marital status may also be useful factors to consider when predicting progression.
本研究旨在确定在宫颈组织学正常或为CIN 1的女性中，预测高危型人乳头瘤病毒（HPV）感染清除以及进展为宫颈上皮内瘤变（CIN）2级或更高等级的因素。
对817例经组织学证实为CIN 1或宫颈组织学正常的高危型HPV感染女性进行回顾性分析。对患者进行了最长24个月的随访。每次就诊时均进行宫颈HPV DNA检测。
随访结束时，817例患者中有648例（79.3%）HPV感染清除，66例（8.1%）进展为CIN 2级或更高等级。诊断时的年龄、产次、细胞学检查结果和病毒载量与HPV清除呈显著负相关。细胞学检查结果、病毒载量和CIN 1病变的存在与病变进展显著相关。
细胞学检查结果和高危型HPV病毒载量可能是预测高危型HPV清除及病变进展可能性的有用指标。组织学状态、产次和婚姻状况在预测进展时也可能是需要考虑的有用因素。
