Evaluation of Cervical Intraepithelial Neoplasia Occurrence Following the Recorded Onset of Persistent High-Risk Human Papillomavirus Infection: A Retrospective Study on Infection Duration.

Cordelle Lazare,Songshu Xiao,Chen Wang,Wending Li,Yifan Meng,Gang Chen,Junbo Hu,Juncheng Wei,Min Xue,Yi Wang,Peng Wu

doi:10.3389/fonc.2019.00976

Abstract

Objectives: Persistent high-risk human papillomavirus infection is a major factor in the development of cervical intraepithelial neoplasia and cervical cancer. However, the exact point during this infection that cervical intraepithelial neoplasia develops has eluded researchers. Therefore, we designed a study investigating infection duration between the recorded onset of persistent high-risk human papillomavirus infection and cervical intraepithelial neoplasia development.Methods: Basic descriptive statistics, including the Chi-square test and the Kaplan-Meier method, were used to retrospectively analyze data of 277 women who underwent human papillomavirus genotyping, exhibited persistent high-risk human papillomavirus infection, were cervical cytology negative at enrollment, and developed cervical intraepithelial neoplasia at some point during follow-up.Results: Mean number of cervical cytology and human papillomavirus tests was 2.31 per patient (range: 2–8). Human papillomavirus 16, 52, 58, and 33 accounted for 21.64% (132/610), 21.64% (132/610), 15.90% (97/610), and 10.66% (65/610) of infections, respectively. 42.24% (117/277) and 57.76% (160/277) of women were diagnosed with cervical intraepithelial neoplasia 1 and cervical intraepithelial neoplasia 2+ after persistent high-risk human papillomavirus infection, with mean follow-up times of 18.15 (11.81) and 19.82 (13.31) months, respectively. Cervical intraepithelial neoplasia occurred between 4 and 70 months following the recorded onset of persistent high-risk human papillomavirus infection and 73.65% (204/277) of women developed cervical intraepithelial neoplasia within 24 months.Conclusion: Human papillomavirus 16, 52, 58, and 33 were the most prevalent high-risk human papillomavirus types in a group of women in which the majority developed cervical intraepithelial neoplasia within 24 months of persistent infection.

Highlights

Cervical cancer (CC) is ranked fourth among leading malignancies in the areas of morbidity and mortality among women worldwide, and persistent infection of any of the 15 highrisk human papillomavirus (HR-HPV) genotypes is necessary for the development of CC and its precursor cervical intraepithelial neoplasia (CIN) [1,2,3]
Among 157,123 women who underwent the aforementioned testing, 277 women who were cervical cytology negative at baseline, exhibited persistent HR-HPV infection throughout follow-up testing and developed CIN were enrolled in this study. 42.24% (117/277) and 57.76% (160/277) developed cervical intraepithelial neoplasia grade 1 (CIN1) and CIN2+, respectively
HPV 16, 52, 58, and 33 were the most prevalent HPV genotypes, accounting for 21.64% (132/610), 21.64% (132/610), 15.90% (97/610), and 10.66% (65/610) of infections, respectively, while all other HRHPV types accounted for 30.16% (184/610)

Summary

Introduction

Cervical cancer (CC) is ranked fourth among leading malignancies in the areas of morbidity and mortality among women worldwide, and persistent infection of any of the 15 highrisk human papillomavirus (HR-HPV) genotypes is necessary for the development of CC and its precursor cervical intraepithelial neoplasia (CIN) [1,2,3]. Several cohort studies have analyzed persistent infection among HR-HPV positive but cervical cytology negative women [6,7,8]. Only 20.5% of enrolled subjects were confirmed to have maintained HRHPV positivity throughout the study’s duration. Such a small percentage of subjects with evidence of maintaining HR-HPV positivity may be insufficient for a convincing conclusion

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Conclusion