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Potential impact of combined high‐ and low‐risk human papillomavirus infection on the progression of cervical intraepithelial neoplasia 2
Author(s) -
Okadome Masao,
Saito Toshiaki,
Tanaka Hideyuki,
Nogawa Takayoshi,
Furuta Reiko,
Watanabe Kayoko,
Kita Tsunekazu,
Yamamoto Kaichiro,
Mikami Mikio,
Takizawa Ken
Publication year - 2014
Publication title -
journal of obstetrics and gynaecology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 50
eISSN - 1447-0756
pISSN - 1341-8076
DOI - 10.1111/jog.12202
Subject(s) - medicine , colposcopy , cervical intraepithelial neoplasia , hazard ratio , hpv infection , odds ratio , confidence interval , human papillomavirus , gynecology , cervical cancer , oncology , cancer , obstetrics
Aim Few studies have examined the effect of combined low‐risk human papillomavirus ( LR‐HPV ) and high‐risk human papillomavirus ( HR‐HPV ) infection on the progression of cervical intraepithelial neoplasia ( CIN )2 to CIN3 . This multi‐institutional prospective cohort study investigated the risk of progression of CIN2 with various combinations of HR‐HPV and LR‐HPV infection. Methods Between J anuary 2007 and M ay 2008, 122 women with CIN2 (aged 20–50 years) from 24 hospitals throughout J apan were enrolled in the study. Ninety‐three women were analyzed after a 2‐year follow‐up with cytology, colposcopy, HR‐HPV testing and HPV genotyping. Colposcopy‐directed biopsy was performed at entry and the end of this study, or when disease progression was suspected. Results Among 93 women with CIN2 , 87 (93.5%) had HR‐HPV infection. Among these 87 cases, 24 (27.6%) progressed to CIN3 and 49 (56.3%) regressed. None of the six women with CIN2 without HR‐HPV infection progressed. The progression rate was significantly lower in women with combined HR‐HPV and LR‐HPV infection (3/28, 10.7%) than in those with HR‐HPV infection only (21/59, 35.6%; P = 0.016). Multivariate analyses showed that CIN2 progression in women with HR‐HPV infection was negatively associated with LR‐HPV co‐infection (hazard ratio = 0.152; 95% confidence interval [ CI ] = 0.042–0.553). CIN2 regression was positively associated with LR‐HPV co‐infection (odds ratio = 4.553; 95% CI = 1.378–15.039). Conclusion The risk of CIN2 progression is low in women with combined infection of HR‐HPV and LR‐HPV . The finding may be useful for management of women diagnosed with CIN2 .