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

Kataja, Vesa; Syrjänen, Kari; Mäntyjärvi, Rauno; Väyrynen, M; Syrjänen, Stina; Saarikoski, Seppo; Parkkinen, Sinikka; Yliskoski, Merja; Salonen, Jukka T.; Castrén, Olli

doi:10.1007/bf00145037

Cited by 68 publications

(42 citation statements)

References 30 publications

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“…Our mean follow-up time was 17.3 + 3.1 years, which is considerably longer than that of any prospective studies (Koss et al 1963;Nasiell et al 1986;Syrj~nen et al 1988;Kataja et al 1989aKataja et al , 1989b. Forty-nine lesions (23.9%) showed no histological evidence of HPV infection (Kadish et al 1986;Koss 1987;Meisels et al 1976;Syrjfinen 1983) (Table 1).…”

Section: Discussionmentioning

confidence: 72%

“…While HPV DNA negativity, HPV6 and HPVll occur commonly in low grade lesions, the grade of the lesion at first biopsy seems to be directly related to clinical course (Table 6). Because of its predictive value, an accurate histological grading of lesions is mandatory (Syrjfinen 1987;Kadish et al 1986;Kataja et al 1989a;Murdoch et al 1988;Syrjfinen et al 1987.…”

Section: Discussionmentioning

confidence: 99%

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Behavior of cervical intraepithelial neoplasia (CIN) associated with various human papillomavirus (HPV) types

Hellberg

Nilsson

Grad

et al. 1993

Arch Gynecol Obstet

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201 cervical punch biopsies which showed CIN lesions and were obtained between 1967 to 1977 from Falu Hospital patients, with long-term follow-up data were examined histologically and by DNA typing for human papillomavirus (HPV). We used in situ hybridization for HPV types 6, 11, 16, 18, 31 and 33 and related our findings to the behaviour of the lesion (103 regressed spontaneously and 98 progressed, some of them to invasive cervical carcinoma). There was evidence of HPV infection in 75.6% (152/201) of these lesions on histological examination, and in 53.2% (107/201) on in situ DNA hybridization. Lesions positive for HPV by both methods occurred in the younger age group (Pearson's correlation coefficient, P = 0.008). HPV 16 was found in 51/152 (33.6%) of the HPV lesions, HPV in 12.5%, and HPV 33 in 8.5% HPV 16 was highly significantly (P = 0.0001), and HPV 18 and HPV 33 were significantly (P = 0.008 and P = 0.007, respectively) associated with increasing grades of CIN. Progression to invasive carcinoma was directly (and regression inversely) correlated with the severity of CIN in the first biopsy (P = 0.005). Almost 74% (17/23) of the HPV-CIN III lesions progressed, while only 25% of the HPV-NCIN lesions (6/24) did so. The progression rate was 84.6% for HPV 33 lesions and 52.9% for HPV 16. On the other hand, progression was less common with HPV 6 (25%), and HPV 31 (30.0%). Histological grade and HPV type appear to be of value as prognostic indices.

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Behavior of cervical intraepithelial neoplasia (CIN) associated with various human papillomavirus (HPV) types

Hellberg

Nilsson

Grad

et al. 1993

Arch Gynecol Obstet

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“…There are 58 HPV types recognized to date. More than 10 HPV types, (HPV 6,11,16,18,31,33,35,39,42,etc. ) have been demonstrated in the genital tract.…”

Section: Introductionmentioning

confidence: 99%

“…The data collected during these years suggest that the natural course of cervical HPV infections is equivalent to that of CIN (28,32,36). In our recent report (11) we used survival analysis to assess the factors associated with either benign or aggressive behavior of the cervical HPV infections. The clinical course of HPV infection was markedly influenced by the grade of the lesion in the first biopsy, i.e.…”

Section: Introductionmentioning

confidence: 99%

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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“…Meanwhile, Kataja et al also reported that 20% of HPV-positive CIN2 progressed to CIN3 over a mean followup period of 45 months. 9 Therefore, it is crucial to elucidate whether or not HPV genotyping is useful to screen patients with CIN2 for higher progression risk who would benefit from more intensive follow-up or therapeutic intervention. In Japan, this is of concern because the incidence of carcinoma in situ (CIS) and that of invasive cervical cancer are rapidly increasing among women aged 39 years.…”

mentioning

confidence: 99%

Incidence risk of cervical intraepithelial neoplasia 3 or more severe lesions is a function of human papillomavirus genotypes and severity of cytological and histological abnormalities in adult Japanese women

Hosaka

Fujita

Hanley

et al. 2012

Intl Journal of Cancer

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We examined incidence probabilities of cervical intraepithelial neoplasia 3 (CIN3) or more severe lesions (CIN3+) in 1,467 adult Japanese women with abnormal cytology in relation to seven common human papillomavirus (HPV) infections (16/18/31/33/35/52/58) between April 2000 and March 2008. Sixty‐seven patients with multiple HPV infection were excluded from the risk factor analysis. Incidence of CIN3+ in 1,400 patients including 68 with ASCUS, 969 with low grade squamous intraepithelial lesion (LSIL), 132 with HSIL without histology‐proven CIN2 (HSIL/CIN2(−)) and 231 with HSIL with histology‐proven CIN2 (HSIL/CIN2(+)) was investigated. In both high grade squamous intraepithelial lesion (HSIL)/CIN2(−) and HSIL/CIN2(+), HPV16/18/33 was associated with a significantly earlier and higher incidence of CIN3+ than HPV31/35/52/58 (p = 0.049 and p = 0.0060, respectively). This association was also observed in LSIL (p = 0.0002). The 1‐year cumulative incidence rate (CIR) of CIN3+ in HSIL/CIN2(−) and HSIL/CIN2(+) according to HPV genotypes (16/18/33 vs. 31/35/52/58) were 27.1% vs. 7.5% and 46.6% vs. 19.2%, respectively. In contrast, progression of HSIL/CIN2(+) to CIN3+ was infrequent when HPV DNA was undetected: 0% of 1‐year CIR and 8.1% of 5‐year CIR. All cervical cancer occurred in HSIL cases of seven high‐risk HPVs (11/198) but not in cases of other HPV or undetectable/negative‐HPV (0/165) (p = 0.0013). In conclusion, incidence of CIN3+ depends on HPV genotypes, severity of cytological abnormalities and histology of CIN2. HSIL/CIN2(+) associated with HPV16/18/33 may justify early therapeutic intervention, while HSIL/CIN2(−) harboring these HPV genotypes needs close observation to detect incidence of CIN3+. A therapeutic intervention is not indicated for CIN2 without HPV DNA.

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

Cited by 68 publications

References 30 publications

Behavior of cervical intraepithelial neoplasia (CIN) associated with various human papillomavirus (HPV) types

Behavior of cervical intraepithelial neoplasia (CIN) associated with various human papillomavirus (HPV) types

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

Incidence risk of cervical intraepithelial neoplasia 3 or more severe lesions is a function of human papillomavirus genotypes and severity of cytological and histological abnormalities in adult Japanese women

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