Multiple human papillomavirus infection and high grade cervical intraepithelial neoplasia among women with cytological diagnosis of atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions

Arsenio Spinillo, Barbara Dal Bello, Barbara Gardella, Marianna Roccio, Maria Diletta Dacco', Enrico Maria Silini

Research output: Contribution to journalArticle

Abstract

Objective: To evaluate the effect of multiple human papillomavirus (HPV) infection on the prevalence of cervical intraepithelial neoplasia (CIN) among women undergoing colposcopy following a cytological diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSIL). Methods: HPV type-specific sequences of 15 high-risk and 10 low risk types were detected by the line probe, INNO-LiPA HPV genotyping assay before colposcopic examination and targeted biopsies. Multinomial logistic regression was used to evaluate the effect of multiple infection on pathologic outcome adjusting for confounders. Results: The prevalence of HPV infection in the 1218 women enrolled was 69.9% (851/1218). HPV 16 (37.4%), 31 (26.1%), 51 (17.4%), 52 (15.7%) and 18 (14%) were the commonest viral types identified. Overall, the rates of multiple infection were 22.5% (153/680) among subjects with negative colposcopy/biopsy, 63.6% (218/343) and 79.5% (155/195) among those with CIN 1 and CIN ≥ 2, respectively (p for trend <.001). The corresponding rates among subjects uninfected by HPV 16 or 18 were 13.5% (77/572), 57.4% (112/195) and 62% (48/77), respectively (p for trend <.001). In multinomial logistic regression, the odds ratio of CIN ≥ 2 in multiple high risk as compared to single high risk HPV infection was 4.33 (95% confidence intervals = 2.32-7.14) in the overall population and 2.76 (95% confidence intervals = 1.36-5.59) among women uninfected by HPV 16 or 18. Conclusions: Multiple HPV infection is a significant risk factor for CIN ≥ 2 among women undergoing colposcopy because of ASCUS/LSIL.

Original languageEnglish
Pages (from-to)115-119
Number of pages5
JournalGynecologic Oncology
Volume113
Issue number1
DOIs
Publication statusPublished - Apr 2009

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Cervical Intraepithelial Neoplasia
Papillomavirus Infections
Colposcopy
Human papillomavirus 16
Human papillomavirus 18
Logistic Models
Confidence Intervals
Biopsy
Infection
Squamous Intraepithelial Lesions of the Cervix
Atypical Squamous Cells of the Cervix
Odds Ratio
Population

Keywords

  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Human papillomavirus
  • Low grade squamous intraepithelial lesions

ASJC Scopus subject areas

  • Obstetrics and Gynaecology
  • Oncology

Cite this

@article{fe7bffc7076840acb434a1502919ac02,
title = "Multiple human papillomavirus infection and high grade cervical intraepithelial neoplasia among women with cytological diagnosis of atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions",
abstract = "Objective: To evaluate the effect of multiple human papillomavirus (HPV) infection on the prevalence of cervical intraepithelial neoplasia (CIN) among women undergoing colposcopy following a cytological diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSIL). Methods: HPV type-specific sequences of 15 high-risk and 10 low risk types were detected by the line probe, INNO-LiPA HPV genotyping assay before colposcopic examination and targeted biopsies. Multinomial logistic regression was used to evaluate the effect of multiple infection on pathologic outcome adjusting for confounders. Results: The prevalence of HPV infection in the 1218 women enrolled was 69.9{\%} (851/1218). HPV 16 (37.4{\%}), 31 (26.1{\%}), 51 (17.4{\%}), 52 (15.7{\%}) and 18 (14{\%}) were the commonest viral types identified. Overall, the rates of multiple infection were 22.5{\%} (153/680) among subjects with negative colposcopy/biopsy, 63.6{\%} (218/343) and 79.5{\%} (155/195) among those with CIN 1 and CIN ≥ 2, respectively (p for trend <.001). The corresponding rates among subjects uninfected by HPV 16 or 18 were 13.5{\%} (77/572), 57.4{\%} (112/195) and 62{\%} (48/77), respectively (p for trend <.001). In multinomial logistic regression, the odds ratio of CIN ≥ 2 in multiple high risk as compared to single high risk HPV infection was 4.33 (95{\%} confidence intervals = 2.32-7.14) in the overall population and 2.76 (95{\%} confidence intervals = 1.36-5.59) among women uninfected by HPV 16 or 18. Conclusions: Multiple HPV infection is a significant risk factor for CIN ≥ 2 among women undergoing colposcopy because of ASCUS/LSIL.",
keywords = "Cervical cancer, Cervical intraepithelial neoplasia, Human papillomavirus, Low grade squamous intraepithelial lesions",
author = "Arsenio Spinillo and {Dal Bello}, Barbara and Barbara Gardella and Marianna Roccio and Dacco', {Maria Diletta} and Silini, {Enrico Maria}",
year = "2009",
month = "4",
doi = "10.1016/j.ygyno.2008.12.037",
language = "English",
volume = "113",
pages = "115--119",
journal = "Gynecologic Oncology",
issn = "0090-8258",
publisher = "Academic Press Inc.",
number = "1",

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TY - JOUR

T1 - Multiple human papillomavirus infection and high grade cervical intraepithelial neoplasia among women with cytological diagnosis of atypical squamous cells of undetermined significance or low grade squamous intraepithelial lesions

AU - Spinillo, Arsenio

AU - Dal Bello, Barbara

AU - Gardella, Barbara

AU - Roccio, Marianna

AU - Dacco', Maria Diletta

AU - Silini, Enrico Maria

PY - 2009/4

Y1 - 2009/4

N2 - Objective: To evaluate the effect of multiple human papillomavirus (HPV) infection on the prevalence of cervical intraepithelial neoplasia (CIN) among women undergoing colposcopy following a cytological diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSIL). Methods: HPV type-specific sequences of 15 high-risk and 10 low risk types were detected by the line probe, INNO-LiPA HPV genotyping assay before colposcopic examination and targeted biopsies. Multinomial logistic regression was used to evaluate the effect of multiple infection on pathologic outcome adjusting for confounders. Results: The prevalence of HPV infection in the 1218 women enrolled was 69.9% (851/1218). HPV 16 (37.4%), 31 (26.1%), 51 (17.4%), 52 (15.7%) and 18 (14%) were the commonest viral types identified. Overall, the rates of multiple infection were 22.5% (153/680) among subjects with negative colposcopy/biopsy, 63.6% (218/343) and 79.5% (155/195) among those with CIN 1 and CIN ≥ 2, respectively (p for trend <.001). The corresponding rates among subjects uninfected by HPV 16 or 18 were 13.5% (77/572), 57.4% (112/195) and 62% (48/77), respectively (p for trend <.001). In multinomial logistic regression, the odds ratio of CIN ≥ 2 in multiple high risk as compared to single high risk HPV infection was 4.33 (95% confidence intervals = 2.32-7.14) in the overall population and 2.76 (95% confidence intervals = 1.36-5.59) among women uninfected by HPV 16 or 18. Conclusions: Multiple HPV infection is a significant risk factor for CIN ≥ 2 among women undergoing colposcopy because of ASCUS/LSIL.

AB - Objective: To evaluate the effect of multiple human papillomavirus (HPV) infection on the prevalence of cervical intraepithelial neoplasia (CIN) among women undergoing colposcopy following a cytological diagnosis of atypical squamous cells of undetermined significance (ASCUS) or low grade squamous intraepithelial lesions (LSIL). Methods: HPV type-specific sequences of 15 high-risk and 10 low risk types were detected by the line probe, INNO-LiPA HPV genotyping assay before colposcopic examination and targeted biopsies. Multinomial logistic regression was used to evaluate the effect of multiple infection on pathologic outcome adjusting for confounders. Results: The prevalence of HPV infection in the 1218 women enrolled was 69.9% (851/1218). HPV 16 (37.4%), 31 (26.1%), 51 (17.4%), 52 (15.7%) and 18 (14%) were the commonest viral types identified. Overall, the rates of multiple infection were 22.5% (153/680) among subjects with negative colposcopy/biopsy, 63.6% (218/343) and 79.5% (155/195) among those with CIN 1 and CIN ≥ 2, respectively (p for trend <.001). The corresponding rates among subjects uninfected by HPV 16 or 18 were 13.5% (77/572), 57.4% (112/195) and 62% (48/77), respectively (p for trend <.001). In multinomial logistic regression, the odds ratio of CIN ≥ 2 in multiple high risk as compared to single high risk HPV infection was 4.33 (95% confidence intervals = 2.32-7.14) in the overall population and 2.76 (95% confidence intervals = 1.36-5.59) among women uninfected by HPV 16 or 18. Conclusions: Multiple HPV infection is a significant risk factor for CIN ≥ 2 among women undergoing colposcopy because of ASCUS/LSIL.

KW - Cervical cancer

KW - Cervical intraepithelial neoplasia

KW - Human papillomavirus

KW - Low grade squamous intraepithelial lesions

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