Invasive cancer of the cervix in women with mild dyskaryosis followed up cytologically

Soutter, W. P.; Fletcher, Astrid

doi:10.1136/bmj.308.6941.1421

Cited by 60 publications

(39 citation statements)

References 17 publications

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“…Thus, HPV-infections are prevalent and often transient among younger women, with a peak of 20-25% at 20-24 years of age. With increasing age, there is a decline in the prevalence of HPV to about 7% at 35 years of age (11). It is likely that most of the HPVpositive women at that age represent a subset of individuals that do not manage to clear their infections spontaneously.…”

Section: Introductionmentioning

confidence: 99%

Expression of E6/E7 mRNA from ‘high risk’ human papillomavirus in relation to CIN grade, viral load and p16INK4a

Andersson¹,

Hansson²,

Norman³

et al. 2006

Int J Oncol

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Abstract. Detection of E6/E7 mRNA expression with real-time nucleic acid sequence-based amplification assay (NASBA) method (PreTect HPV-Proofer) from high-risk types of human papillomaviruses (HR-HPV) were compared with the presence of viral load, determined with quantitative real-time PCR in 80 cervical samples. Results regarding positivity and typing were in agreement using the two methods. However, there was no correlation between viral loads for HPV 16 or 18/45 and oncogene expression. Among 15 women with low grade atypia detected at a population-based cytology screening, and scored as 'within normal limits' according to histopathology, 14% were positive for oncogene expression, whereas 71% were HR-HPV positive. A correlation was observed between HR-HPV oncogene expression and high scores of p16 INK4a positivity. Since HPV-Proofer detects full-length E6/E7 mRNA, a positive result should correlate with presence of integrated HPV, loss of HPV replication and stabilized E6/E7 fulllength mRNA expression. Such expression from integrated HR-HPV generates a high and stable expression of full-length E6 proteins, which explains why a positive HPV-Proofer result was independent of viral load and correlate with high expression of p16 INK4a . Thus, E6/E7 oncogene expression analysis yielded information, which is consistent with and will complement the results from a real-time PCR method in a clinical prognostic procedure.

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Section: Introductionmentioning

confidence: 99%

Expression of E6/E7 mRNA from ‘high risk’ human papillomavirus in relation to CIN grade, viral load and p16INK4a

Andersson¹,

Hansson²,

Norman³

et al. 2006

Int J Oncol

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“…HPV infections are prevalent and often transient among younger women, with a peak of 20 -25% at 20 -24 years of age. With increasing age, there is a decline in the prevalence of HPV to about 7% at 35 years of age (Soutter and Fletcher, 1994). It is likely that HPV-positive women at that age represent a subset of individuals who do not manage to clear their infections spontaneously.…”

mentioning

confidence: 99%

Type distribution, viral load and integration status of high-risk human papillomaviruses in pre-stages of cervical cancer (CIN)

et al. 2005

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A series of 176 archival cervical intraepithelial neoplasia (CIN) was analysed for the presence, viral load and integration status of 'highrisk' types of human papillomavirus (HR-HPV). The samples were assayed using newly developed methods based on real-time PCR. Two methods for the extraction of DNA from the paraffin-embedded biopsies were compared: a protocol based on the MagNA pure system (Roche) and a Qiagen spin column kit (Qiagen). It was possible to amplify 94% (166) of the samples. Of these, 36, 63 and 80% of the CIN I, II and III cases contained HR-HPV. HPV 16 was the most prevalent, and was found in 20, 28 and 46% of the CIN I, II and III cases, respectively. The second most frequent HR-HPV was type 33 group, and in CIN II it was as prevalent as HPV 16. The median number of copies of HR-HPV per cell was not significantly different in the CIN I, II and III cases, but there was a wide range of viral load values over several magnitudes, regardless of the grade of CIN. All samples were found to contain integrated forms of HPV 16, frequently mixed with an episomal form.

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“…Several risk factors have been noted for cervical premalignancies and cervical cancer. 213 Some of them are human papillomavirus (HPV) infections, 4ti previous dyskaryotic smears 6 and the diagnosis of CIN. Women with these risk factors should be followed up routinely.…”

mentioning

confidence: 99%

Cervical Neoplasia in Pap Smears: Risk of Cervical Intra-Epithelial Neoplasia (CIN) after Negative or No Prior Smears in a Population without a Mass Screening Programme

1996

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Stalsberg H. Cervical neoplasia in Pap smears. Risk of cervical intra-epithelial neoplasia (CIN) after negative or no prior smears in a population without a mass screening programme International Journal of Epidemiology 1996; 25: 53-58. Background. The aim of this study was to examine, In a population not submitted to mass screening, the risk of cancer and cervical intra-epithelial neoplasia (CIN) in Pap smears from women without previously reported positive smears. Methods. In a logistic regression model consisting of 58 271 smears from 40 536 Norwegian women the risk of cytologically indicated CIN was studied according to age and time elapsed since last smear. Results. The risk of CIN was highest In smears from women with no previously registered smears and in smears taken after an interval of *5 years. Odds ratio for CIN Ml adjusted for age was highest in first time smears and In smears taken after an interval of 5 years. Odds ratio for CIN III was highest In first registered smears. No difference in risk of CIN III was found in smears taken within one year or 2-3 years after the last smear. The increased risk of CIN III In first smears was most pronounced in postmenopausal women (>50 years). Nine of 16 cases with cytological indication of cancer were found in women having a smear taken for the first time. All cases with malignancy In smears were >50 years. Conclusions. The risk of cytologically diagnosed premalignant cervical conditions increases with time since the previous smear, but more than 5 years have to elapse before the risk is comparable with that in first smears taken. Postmenopausal women without previous smears run the highest risk of serious cervical premallgnancies and cancer. Several risk factors have been noted for cervical premalignancies and cervical cancer.213 Some of them are human papillomavirus (HPV) infections, 4ti previous dyskaryotic smears 6 and the diagnosis of CIN. Women with these risk factors should be followed up routinely. As the main objectives of a screening programme for cervical cancer are to detect precursors for disease and early cancer in women without known major risk factors, we believe it is important to evaluate the risk of having smears indicating CIN and cancer in these women. Two variables of obvious interest are the age of the woman and the period elapsed since the last negative smear. It is the aim of the present study to evaluate this risk. The study population includes the results of more than 58 000 smears from 40 000 women without previously noted positive smears in a population with frequent Pap smear testing, but no organized screening programme.

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Invasive cancer of the cervix in women with mild dyskaryosis followed up cytologically

Cited by 60 publications

References 17 publications

Expression of E6/E7 mRNA from ‘high risk’ human papillomavirus in relation to CIN grade, viral load and p16INK4a

Expression of E6/E7 mRNA from ‘high risk’ human papillomavirus in relation to CIN grade, viral load and p16INK4a

Type distribution, viral load and integration status of high-risk human papillomaviruses in pre-stages of cervical cancer (CIN)

Cervical Neoplasia in Pap Smears: Risk of Cervical Intra-Epithelial Neoplasia (CIN) after Negative or No Prior Smears in a Population without a Mass Screening Programme

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