So Kyeong A, Kim Seon Ah, Lee Yoo Kyung, Lee In Ho, Lee Ki Heon, Rhee Jee Eun, Kee Mee Kyung, Cho Chi Heum, Hong Sung Ran, Hwang Chang Sun, Jeong Mi Seon, Kim Ki Tae, Ki Moran, Hur Soo Young, Park Jong Sup, Kim Tae Jin
Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University, Seoul, Korea.
Division of Viral Disease Research Center for Infectious Disease Research, National Institute of Health, Korea Centers for Disease Control and Prevention, Cheongju, Korea.
Obstet Gynecol Sci. 2018 Nov;61(6):662-668. doi: 10.5468/ogs.2018.61.6.662. Epub 2018 Oct 15.
This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL).
We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing.
Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; =0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00).
The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.
本研究旨在确定意义不明确的非典型鳞状细胞（ASC-US）或低级别鳞状上皮内病变（LSIL）女性细胞学进展的危险因素。
我们分析了参与韩国人乳头瘤病毒（HPV）队列研究的感染HPV女性的数据。该队列于2010年4月招募了年龄在20至60岁之间、宫颈细胞学异常（ASC-US或LSIL）的女性。所有女性每6个月进行一次宫颈细胞学和HPV DNA检测随访。
在纳入的1158名女性中，分别有654名（56.5%）和504名（43.5%）女性表现为ASC-US和LSIL。在入组时，143名女性HPV 16检测呈阳性（85例单一感染和58例多重感染）。在6个月的随访中，HPV 16阳性女性的宫颈细胞学检查显示，27%的女性病情进展，23%的女性无变化，50%的女性病情消退。与HPV 16感染相关的进展率高于其他HPV类型感染所致的进展率（相对风险[RR]，1.75；95%置信区间[CI]，1.08 - 2.84；P = 0.028）。持续HPV 16感染女性的细胞学进展率高于偶然感染或已清除感染的女性（P<0.001）。逻辑回归分析显示吸烟与细胞学进展之间存在显著关联（RR，4.15；95% CI，1.01 - 17.00）。
ASC-US或LSIL的HPV 16阳性女性的细胞学进展率高于其他HPV类型感染的女性。此外，吸烟可能在细胞学进展中起作用。
