Behavior of Mild Cervical Dysplasia During Long-Term Follow-up

Nasiell, K; Roger, V.; Nasiell, M

doi:10.1097/00006250-198605000-00012

Cited by 313 publications

(105 citation statements)

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“…The progression and regression rates observed in our series are consonant with the observations made by most other investigators (7, 19,23). On the other hand, progression rates greater than 50% have also been reported (2).…”

Section: Discussionsupporting

confidence: 93%

Prospective follow-up of genital HPV infections: Survival analysis of the HPV typing data

Kataja¹,

Syrjänen²,

Syrjänen³

et al. 1990

Eur J Epidemiol

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A series of 532 women with genital HPV infections has been prospectively followed-up without treatment since 1981 for a mean of 50 (+/-21) months. The patients were examined at six month intervals by colposcopy, PAP smears and/or biopsy. HPV typing of all biopsies was completed using in situ, Southern blot and/or sandwich hybridization with DNA probes for types 6, 11, 16, 18, 31 and 33. Survival data analysis was applied to analyse the clinical course (i.e. spontaneous regression and progression) of the HPV lesions stratified by their HPV type, currently available for 458 women. Clinical progression was significantly related to the HPV type present in the lesions. The progression rate was 11.1% (6/54) for HPV 6 lesions, 14.3% (8/56) for HPV 11, 35.2% (32/91) for HPV 16, 12.5% (4/32) for HPV 18, 18.8% (6/32) for HPV 31, 19.4% (6/31) for HPV 33 and 28.6% (4/14) for doubly infected lesions. The lowest progression rate, 6.1% (9/148), was found in lesions which remained constantly HPV DNA-negative. In the survival analysis the probability of progression varied significantly between the six HPV types (p = 0.0005, overall). After grouping the viral types as HPV 6/11 ('low risk'), HPV 16/18 ('high risk') and HPV 31/33 ('intermediate risk') the overall probability of progression remained significantly different (p = 0.0035, overall). In clinical regression, however, the HPV type was not an equally good predictor (p = 0.1952, overall). Within groups HPV 6/11, 16/18 and 31/33 the differences were even less significant (p = 0.4759, overall). In the pairwise comparison significant differences in progression occurred when HPV type 16 was compared to HPV 6, HPV 11 or HPV DNA-negative lesions.(ABSTRACT TRUNCATED AT 250 WORDS)

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Section: Discussionsupporting

confidence: 93%

Prospective follow-up of genital HPV infections: Survival analysis of the HPV typing data

Kataja¹,

Syrjänen²,

Syrjänen³

et al. 1990

Eur J Epidemiol

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“…Our follow-up results suggest that the natural history of cervical HPV infections is very similar to that of CIN (30,31,32), known to be capable of progressing into a frankly invasive cancer if left untreated (13,24). These data (30) also support the concept of "low risk" (HPV 6 and 11) and "high risk" (HPV 16,18,31,33,35,39) HPV types in cervical carcinogenesis (2,4,7,12,15,22,31).…”

Section: Introductionsupporting

confidence: 72%

“…The grade of CIN was assessed using the commonly accepted criteria for C1N I, II and III (23,24). Human papillomavirus lesions without concomitant CIN were called HPV-NCIN as contrasted to HPV-CIN, i.e.…”

Section: Cervical Punch Biopsymentioning

confidence: 99%

Prospective follow-up of cervical HPV infections: Life table analysis of histopathological, cytological and colposcopic data

Kataja

Syrjänen²,

Mäntyjärvi

et al. 1989

Eur J Epidemiol

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A total of 532 women with established cervical HPV infection have been prospectively followed (without treatment) since 1981 for a mean of 45 (SD 21) months. The patients were examined by colposcopy, PAP smears and/or punch biopsy every 6 months. The life-table method was applied to analyze the clinical course (i.e. regression and progression) of the HPV lesions, stratified by their colposcopic pattern, PAP smear findings and grade of CIN. During the follow-up, 107 (41.8%) of 256 patients with HPV-NCIN lesion in the first punch biopsy, experienced spontaneous regression. The corresponding proportions for HPV-CIN I, HPV-CIN II and HPV-CIN III lesions were 31.1%, 34.2%, and 20.7%, respectively. In the overall comparison between these four groups, the heterogeneity in the probability of regression was statistically significant (p = 0.0005). Clinical progression was also associated significantly with the histological grade of the lesions in the first biopsy. Progression rate was only 5.8% for HPV-NCIN lesions, as compared to 12.3% for HPV-CIN I, 20% for HPV-CIN II, and 55.2% for HPV-CIN III. The probability of progression varied significantly between the four groups (p less than 0.00001). Cumulative proportion of regression was 46% for patients with PAP smear class I, 84% with class II, and 82% for those with class III, cells, i.e. PAP smear was not of value in predicting the regression. However, PAP smears predicted clinical progression (p = 0.006 overall).(ABSTRACT TRUNCATED AT 250 WORDS)

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“…The regression typically occurs within a 2-year follow-up period as seen with cytology and colposcopy, which has led to the recommendation that patients with mild dysplasia may be treated by observation [7,8]. According to 2006 consensus guideline by The American Society for Colposcopy and Cervical Pathology (ASCCP) recommended general management of women with atypical squamous cell of undetermined significance (ASCUS) is follow-up with repeat cytologic testing at 12 months and with low-grade squamous intraepithelial lesions (LSIL) colposcopy and testing for high-risk types of human papilloma virus (HPV) at 12 months or repeat cervical cytologic testing at 6 and 12 months [9].…”

Section: Introductionmentioning

confidence: 99%

Mode of Delivery Influences the Regression of Abnormal Cervical Cytology

Chung

Son

Nam

et al. 2011

Gynecol Obstet Invest

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Aims: The purpose was to investigate the influence of delivery mode on the postpartum regression of abnormal cervical cytology. Methods: A retrospective review was conducted of 64 pregnant women with abnormal cervical cytology at Yonsei University Health System in Korea between 2001 and 2008. A Papanicolaou smear and pathological data were categorized into three groups by cervical intraepithelial neoplasia classification. Postpartum evaluation was taken 3–6 months after delivery. The regression rates of cervical cytologic findings were compared between the vaginal delivery group and Cesarean section group. p < 0.05 was considered significant. Results: Of the 64 women, 45 (70.3%) were delivered vaginally and 19 (29.7%) by cesarean section. No significant difference was found between the two groups with respect to age, gestational age, parity, smoking, and HPV (human papilloma virus) screening. Postpartum regression was shown in 39 (92.9%) women who delivered vaginally and in 12 (63.2%) women who underwent cesarean section (p = 0.016). In the cesarean section group, 1 patient had progressed from CIN2 to microinvasive cancer and 2 patients from carcinoma in situ to invasive cancer. Conclusion: The rate of spontaneous regression of antepartum abnormal cervical cytology was higher after vaginal delivery.

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Behavior of Mild Cervical Dysplasia During Long-Term Follow-up

Cited by 313 publications

References 0 publications

Prospective follow-up of genital HPV infections: Survival analysis of the HPV typing data

Prospective follow-up of genital HPV infections: Survival analysis of the HPV typing data

Prospective follow-up of cervical HPV infections: Life table analysis of histopathological, cytological and colposcopic data

Mode of Delivery Influences the Regression of Abnormal Cervical Cytology

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