Retrospective study of the influence of HPV persistence on outcomes among women with high-risk HPV infections and negative cytology

Giorgio Bogani, Francesca Taverna, Claudia Lombardo, Chiara Borghi, Fabio Martinelli, Mauro Signorelli, Umberto Leone Roberti Maggiore, Valentina Chiappa, Cono Scaffa, Antonino Ditto, Domenica Lorusso, Francesco Raspagliesi

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Abstract

Objective: To evaluate the outcomes of women diagnosed with high-risk HPV without cytology evidence of cervical dysplasia. Methods: The present retrospective observational study enrolled consecutive women aged at least 18 years diagnosed with high-risk HPV types with negative cytology results at the National Cancer Institute, Milan, Italy, between January 1, 2005, and December 31, 2015. The development of cervical intraepithelial neoplasia (CIN) was assessed. Results: There were 212 patients with high-risk HPV infections with negative cytology included in the analysis. After a mean ± SD follow-up period of 48 ± 33 months, 65 (30.7%) and 26 (12.3%) patients had developed cytologic or histologic cervical dysplasia (low-grade squamous intraepithelial lesion [LSIL]/CIN1+) and high-grade cervical dysplasia (CIN2+), respectively. No patients had invasive cancer. No correlations were observed between type-specific HPV infections and LSIL/CIN1+ and CIN2+. HPV persistence correlated with both LSIL/CIN1+ (P<0.001) and CIN2+ (P<0.001) in univariate analyses; a 6-month increase in HPV persistence was associated with increased risk of developing LSIL/CIN1+ (P=0.010) and CIN2+ (P=0.012) in multivariate analyses. Conclusions: Regardless of cytology findings, patients diagnosed with high-risk HPV types should receive strict colposcopy follow-up, particularly with persistent HPV infections. Further prospective studies are needed to defined optimal surveillance strategies for these patients.

Original languageEnglish
Pages (from-to)62-68
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume138
Issue number1
DOIs
Publication statusPublished - Jul 1 2017

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Cell Biology
Uterine Cervical Dysplasia
Retrospective Studies
Infection
Colposcopy
Cervical Intraepithelial Neoplasia
National Cancer Institute (U.S.)
Italy
Observational Studies
Multivariate Analysis
Prospective Studies
Squamous Intraepithelial Lesions of the Cervix
Neoplasms

Keywords

  • Cervical dysplasia
  • CIN
  • HPV persistence
  • Human papillomavirus

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

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title = "Retrospective study of the influence of HPV persistence on outcomes among women with high-risk HPV infections and negative cytology",
abstract = "Objective: To evaluate the outcomes of women diagnosed with high-risk HPV without cytology evidence of cervical dysplasia. Methods: The present retrospective observational study enrolled consecutive women aged at least 18 years diagnosed with high-risk HPV types with negative cytology results at the National Cancer Institute, Milan, Italy, between January 1, 2005, and December 31, 2015. The development of cervical intraepithelial neoplasia (CIN) was assessed. Results: There were 212 patients with high-risk HPV infections with negative cytology included in the analysis. After a mean ± SD follow-up period of 48 ± 33 months, 65 (30.7{\%}) and 26 (12.3{\%}) patients had developed cytologic or histologic cervical dysplasia (low-grade squamous intraepithelial lesion [LSIL]/CIN1+) and high-grade cervical dysplasia (CIN2+), respectively. No patients had invasive cancer. No correlations were observed between type-specific HPV infections and LSIL/CIN1+ and CIN2+. HPV persistence correlated with both LSIL/CIN1+ (P<0.001) and CIN2+ (P<0.001) in univariate analyses; a 6-month increase in HPV persistence was associated with increased risk of developing LSIL/CIN1+ (P=0.010) and CIN2+ (P=0.012) in multivariate analyses. Conclusions: Regardless of cytology findings, patients diagnosed with high-risk HPV types should receive strict colposcopy follow-up, particularly with persistent HPV infections. Further prospective studies are needed to defined optimal surveillance strategies for these patients.",
keywords = "Cervical dysplasia, CIN, HPV persistence, Human papillomavirus",
author = "Giorgio Bogani and Francesca Taverna and Claudia Lombardo and Chiara Borghi and Fabio Martinelli and Mauro Signorelli and {Leone Roberti Maggiore}, Umberto and Valentina Chiappa and Cono Scaffa and Antonino Ditto and Domenica Lorusso and Francesco Raspagliesi",
year = "2017",
month = "7",
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doi = "10.1002/ijgo.12170",
language = "English",
volume = "138",
pages = "62--68",
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T1 - Retrospective study of the influence of HPV persistence on outcomes among women with high-risk HPV infections and negative cytology

AU - Bogani, Giorgio

AU - Taverna, Francesca

AU - Lombardo, Claudia

AU - Borghi, Chiara

AU - Martinelli, Fabio

AU - Signorelli, Mauro

AU - Leone Roberti Maggiore, Umberto

AU - Chiappa, Valentina

AU - Scaffa, Cono

AU - Ditto, Antonino

AU - Lorusso, Domenica

AU - Raspagliesi, Francesco

PY - 2017/7/1

Y1 - 2017/7/1

N2 - Objective: To evaluate the outcomes of women diagnosed with high-risk HPV without cytology evidence of cervical dysplasia. Methods: The present retrospective observational study enrolled consecutive women aged at least 18 years diagnosed with high-risk HPV types with negative cytology results at the National Cancer Institute, Milan, Italy, between January 1, 2005, and December 31, 2015. The development of cervical intraepithelial neoplasia (CIN) was assessed. Results: There were 212 patients with high-risk HPV infections with negative cytology included in the analysis. After a mean ± SD follow-up period of 48 ± 33 months, 65 (30.7%) and 26 (12.3%) patients had developed cytologic or histologic cervical dysplasia (low-grade squamous intraepithelial lesion [LSIL]/CIN1+) and high-grade cervical dysplasia (CIN2+), respectively. No patients had invasive cancer. No correlations were observed between type-specific HPV infections and LSIL/CIN1+ and CIN2+. HPV persistence correlated with both LSIL/CIN1+ (P<0.001) and CIN2+ (P<0.001) in univariate analyses; a 6-month increase in HPV persistence was associated with increased risk of developing LSIL/CIN1+ (P=0.010) and CIN2+ (P=0.012) in multivariate analyses. Conclusions: Regardless of cytology findings, patients diagnosed with high-risk HPV types should receive strict colposcopy follow-up, particularly with persistent HPV infections. Further prospective studies are needed to defined optimal surveillance strategies for these patients.

AB - Objective: To evaluate the outcomes of women diagnosed with high-risk HPV without cytology evidence of cervical dysplasia. Methods: The present retrospective observational study enrolled consecutive women aged at least 18 years diagnosed with high-risk HPV types with negative cytology results at the National Cancer Institute, Milan, Italy, between January 1, 2005, and December 31, 2015. The development of cervical intraepithelial neoplasia (CIN) was assessed. Results: There were 212 patients with high-risk HPV infections with negative cytology included in the analysis. After a mean ± SD follow-up period of 48 ± 33 months, 65 (30.7%) and 26 (12.3%) patients had developed cytologic or histologic cervical dysplasia (low-grade squamous intraepithelial lesion [LSIL]/CIN1+) and high-grade cervical dysplasia (CIN2+), respectively. No patients had invasive cancer. No correlations were observed between type-specific HPV infections and LSIL/CIN1+ and CIN2+. HPV persistence correlated with both LSIL/CIN1+ (P<0.001) and CIN2+ (P<0.001) in univariate analyses; a 6-month increase in HPV persistence was associated with increased risk of developing LSIL/CIN1+ (P=0.010) and CIN2+ (P=0.012) in multivariate analyses. Conclusions: Regardless of cytology findings, patients diagnosed with high-risk HPV types should receive strict colposcopy follow-up, particularly with persistent HPV infections. Further prospective studies are needed to defined optimal surveillance strategies for these patients.

KW - Cervical dysplasia

KW - CIN

KW - HPV persistence

KW - Human papillomavirus

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