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Type: Artigo de periódico
Title: Co-factors of high-risk human papillomavirus infections display unique profiles in incident CIN1, CIN2 and CIN3
Author: Syrjanen, K
Shabalova, I
Naud, P
Derchain, S
Sarian, L
Kozachenko, V
Zakharchenko, S
Roteli-Martins, C
Nerovjna, R
Longatto-Filho, A
Kljukina, L
Tatti, S
Branovskaja, M
Branca, M
Grunjberga, V
Erzen, M
Juschenko, A
Hammes, LS
Costa, S
Podistov, J
Syrjanen, S
Abstract: In addition to oncogenic 'high-risk' human papillomaviruses (HR-HPV), several co-factors are needed in cervical carcinogenesis, but it is poorly understood whether these HPV co-factors associated with incident cervical intraepithelial neoplasia (CIN) grade 1 are different from those required for progression to CIN2 and CIN3. To gain further insights into the true biological differences between CIN1, CIN2 and CIN3, we assessed HPV co-factors increasing the risk of incident CIN1, CIN2 and CIN3. Data from the New Independent States of the Former Soviet Union (NIS) Cohort (n = 3187) and the Latin American Screening (LAMS) Study (n = 12,114) were combined, and co-factors associated with progression to CIN1, CIN2 and CIN3 were analysed using multinomial logistic regression models with all covariates recorded at baseline. HR-HPV-positive women (n = 1105) represented a subcohort of all 1865 women prospectively followed up in both studies. Altogether, 90(4.8%), 39 (2.1%) and 14 (1.4%) cases progressed to CIN1, CIN2 and CIN3, respectively. Baseline HR-HPV was the single most powerful predictor of incident CIN1, CIN2 and CIN3. When controlled for residual HPV confounding by analysing HR-HPV-positive women only, the risk profiles of incident CIN1, CIN2 and CIN3 were unique. Completely different HPV co-factors were associated with progression to CIN1, CIN2 and CIN3 in univariate and multivariate analyses, irrespective of whether non-progression, CIN1 or CIN2 was used as the reference outcome. HPV co-factors associated with progression to CIN1, CIN2 and CIN3 display unique profiles, implicating genuine biological differences between the three CIN grades, which prompts us to re-visit the concept of combining CIN2 with CIN3 or CIN1.
Subject: CIN
multinomial regression
prospective follow-up
NIS Cohort
LAMS Study
Country: Inglaterra
Editor: Royal Soc Medicine Press Ltd
Citation: International Journal Of Std & Aids. Royal Soc Medicine Press Ltd, v. 22, n. 5, n. 263, n. 272, 2011.
Rights: fechado
Identifier DOI: 10.1258/ijsa.2009.009280
Date Issue: 2011
Appears in Collections:Unicamp - Artigos e Outros Documentos

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