Heard I, Bergeron C, Jeannel D, Henrion R, Kazatchkine M D
Unité d'Immunopathologic, Hôpital Broussais, Paris, France.
Obstet Gynecol. 1995 Nov;86(5):749-53. doi: 10.1016/0029-7844(95)00282-V.
To assess the outcome of cervical squamous intraepithelial lesions (SIL) in human immunodeficiency virus (HIV)-seropositive women.
Papanicolaou smears were followed-up prospectively in a group of 60 HIV-positive women every 6 months for 18 months.
The cumulative incidence of SIL at 18 months was 9% in 27 women who presented with normal Papanicolaou smears at entry. In 33 women who initially presented with SIL, the rate of persistence of cervical lesions was 95% (18 of 19) in untreated patients and 61% (eight of 13) in women who underwent surgery. In women with low-grade SIL, the persistence or progression of cervical lesions was observed in 92% of the cases (12 of 13). No invasive cancer was observed during the 18 months of the study period.
Although the long-term outcome of SIL in this population remains unknown, our results emphasize the high rate of persistence of SIL and the relative inefficiency of conventional treatment in HIV-infected women. These findings contrast with the natural history of SIL in immunocompetent women.
评估人类免疫缺陷病毒（HIV）血清反应阳性女性宫颈鳞状上皮内病变（SIL）的转归情况。
对一组60例HIV阳性女性的巴氏涂片进行前瞻性随访，每6个月随访一次，共随访18个月。
在入组时巴氏涂片正常的27名女性中，18个月时SIL的累积发病率为9%。在最初表现为SIL的33名女性中，未治疗患者宫颈病变的持续率为95%（19例中的18例），接受手术治疗的女性为61%（13例中的8例）。在低度SIL女性中，92%的病例（13例中的12例）观察到宫颈病变持续或进展。在研究的18个月期间未观察到浸润癌。
尽管该人群中SIL的长期转归尚不清楚，但我们的结果强调了SIL的高持续率以及传统治疗对HIV感染女性相对无效。这些发现与免疫功能正常女性中SIL的自然史形成对比。
