Produção Nacional
Revisado por pares
Co-factors of high-risk human papillomavirus infections display unique profiles in incident CIN1, CIN2 and CIN3
2011; SAGE Publishing; Volume: 22; Issue: 5 Linguagem: Inglês
10.1258/ijsa.2009.009280
ISSN1758-1052
AutoresKarí Syrjänen, I. P. Shabalova, Paulo Naud, Sophie Derchain, Luı́s Otávio Sarian, В. П. Козаченко, S Zakharchenko, Cecília Roteli-Martins, Raisa Nerovjna, Adhemar Longatto‐Filho, Ludmila Kljukina, Sílvio Tatti, Marina Branovskaja, M Branca, V Grunjberga, Mojca Eržen, Anna Juschenko, L S Hammes, S Costa, J Podistov, Stina Syrjänen, I. P. Shabalova, Н Н Петровичев, В. П. Козаченко, T. Zakharova, Julia Pajanidi, J Podistov, G. Yu. Chemeris, Larisa G. Sozaeva, Elena Lipova, Irena Tsidaeva, Olga Ivanchenko, Alla Pshepurko, Sergej Zakharenko, Raisa Nerovjna, Ludmila Kljukina, Oksana Erokhina, Marina Branovskaja, Maritta Ņikitina, V Grunjberga, A Grunjberg, Anna Juschenko, Rosa Santopietro, Marcella Cintorino, P Tosi,
Tópico(s)Reproductive tract infections research
ResumoIn 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.
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