High-risk HPV-positive and-negative high-grade cervical dysplasia: Analysis of 5-year outcomes

被引：47

作者：

Bogani, Giorgio ^{[1
]}

Sopracordevole, Francesco ^{[2
]}

Di Donato, Violante ^{[3
]}

Ciavattini, Andrea ^{[4
]}

Ghelardi, Alessandro ^{[5
]}

Lopez, Salvatore ^{[1
]}

Simoncini, Tommaso ^{[6
]}

Plotti, Francesco ^{[7
]}

Casarin, Jvan ^{[8
]}

Serati, Maurizio ^{[8
]}

Pinelli, Ciro ^{[9
]}

Valenti, Gaetano ^{[3
]}

Bergamini, Alice ^{[10
]}

Gardella, Barbara ^{[11
]}

Dell'acqua, Andrea ^{[12
]}

Monti, Ermelinda ^{[12
]}

Vercellini, Paolo ^{[12
]}

Fischetti, Margherita ^{[3
]}

D'ippolito, Giovanni ^{[13
]}

Aguzzoli, Lorenzo ^{[13
]}

Mandato, Vincenzo D. ^{[13
]}

Carunchio, Paola ^{[13
]}

Carlinfante, Gabriele ^{[13
]}

Giannella, Luca ^{[4
]}

Scaffa, Cono ^{[14
]}

Falcone, Francesca ^{[14
]}

Borghi, Chiara ^{[15
]}

Ditto, Antonino ^{[1
]}

Malzoni, Mario ^{[16
]}

Giannini, Andrea ^{[17
]}

Salerno, Maria Giovanna ^{[17
]}

Liberale, Viola ^{[18
]}

Contino, Biagio ^{[18
]}

Donfrancesco, Cristina ^{[19
]}

Desiato, Michele ^{[19
]}

Perrone, Anna Myriam ^{[20
]}

Dondi, Giulia ^{[20
]}

De Iaco, Pierandrea ^{[20
]}

Chiappa, Valentina ^{[1
]}

Ferrero, Simone ^{[21
,22
]}

Sarpietro, Giuseppe ^{[23
]}

Matarazzo, Maria G. ^{[23
]}

Cianci, Antonio ^{[23
]}

Bosio, Sara ^{[24
]}

Ruisi, Simona ^{[24
]}

Guerrisi, Rocco ^{[9
]}

Brusadelli, Claudia ^{[9
]}

Mosca, Lavinia ^{[25
]}

Lagana, Antonio Simone ^{[8
]}

Tinelli, Raffaele ^{[26
]}

机构：

[1] Fdn IRCCS Ist Nazl Tumori Milano, Gynecol Oncol Unit, Milan, Italy

[2] Natl Canc Inst, Ctr Riferimento Oncol, Gynecol Oncol Unit, Via F Gallini 2, I-33081 Aviano, Italy

[3] Sapienza Univ Rome, Dept Gynecol Obstet & Urol Sci, Rome, Italy

[4] Polytech Univ Marche, Gynecol Sect, Womans Hlth Sci Dept, Ancona, Italy

[5] Osped Apuane, Azienda Usl Toscana Nord Ovest, UOC Ostetricia & Ginecol, Massa, Italy

[6] Univ Pisa, Dept Clin & Expt Med, Pisa, Italy

[7] Campus Biomed Univ Rome, Rome, Italy

[8] Univ Insubria, Filippo Del Ponte Hosp, Dept Obstet & Gynecol, Varese, Italy

[9] Osped Circolo Fdn Macchi, Varese, Italy

[10] IRCCS Osped San Raffaele, Dept Obstet & Gynecol, Milan, Italy

[11] Univ Pavia, IRCCS S Matteo Fdn, Dept Clin Surg Diagnost & Paediat Sci, Pavia, Italy

[12] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gynaecol Unit, Milan, Italy

[13] Azienda Unita Sanit Locale IRCCS Reggio Emilia, Cesare Magati Hosp, Div Obstet & Gynecol, Scandiano, Italy

[14] IRCCS Fdn G Pascale, Ist Nazl Tumori, Gynecol Oncol Unit, Naples, Italy

[15] S Anna Univ Hosp, Dept Obstet & Gynecol, Ferrara, Italy

[16] Ctr Adv Endoscop Gynecol Surg, Endoscop Malzoni, Avellino, Italy

[17] San Camillo Forlanini Hosp, Dept Womans & Childs Hlth, Obstet & Gynecol Unit, Rome, Italy

[18] Osped Maria Vittoria, Dept Obstet & Gynecol, Turin, Italy

[19] Osped S Trinita Sora, Dept Obstet & Gynecol, Azienda ASL Frosinone, Sora, Italy

[20] St Orsola Malpighi Hosp, Gynecol Oncol Unit, I-40138 Bologna, Italy

[21] IRCCS Osped Policlin San Martino, Acad Unit Obstet & Gynecol, Genoa, Italy

[22] Univ Genoa, Dept Neurosci Rehabil Ophthalmol Genet Maternal &, Genoa, Italy

[23] Univ Catania, Gynecol Clin, Dept Gen Surg & Med Surg Specialties, Via S Sofia 78, I-95124 Catania, Italy

[24] Univ Milan, San Paolo Hosp, I-20142 Milan, Italy

[25] Univ Campania Luigi Vanvitelli, Dept Woman Child & Gen & Specialized Surg, I-80138 Naples, Italy

[26] Valle Itria Hosp, Dept Obstet & Gynecol, Via San Francesco da Paola, I-74015 Taranto, Italy

[27] Fdn Policlin Univ A Gemelli, IRCCS, Dipartimento Salute Donna & Bambino & Salute Pubb, UOC Ginecol Oncol, Rome, Italy

[28] Univ Sassari, Gynecol & Obstet Unit, Dept Med Surg & Expt Sci, Sassari, Italy

[29] Univ Naples Federico II, Dept Neurosci Reprod Sci & Dent, Sch Med, Naples, Italy

来源：

GYNECOLOGIC ONCOLOGY | 2021年 / 161卷 / 01期

关键词：

HPV; Negative; Positive; CIN; Conization; CANCER; NEOPLASIA; SUBTYPES; WOMEN;

D O I：

10.1016/j.ygyno.2021.01.020

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

Objective. To evaluate the outcomes of high-risk (HR) HPV-positive and-negative women affected by high-grade cervical dysplasia. Methods. This is a retrospective multi-institutional study. Medical records of consecutive patients with high-grade cervical dysplasia undergoing conization between 2010 and 2014 were retrieved. All patients included had at least 5 years of follow-up. A propensity-score matching was adopted in order to reduce the presence of con-founding factors between groups. Kaplan-Meir and Cox hazard models were used to estimate 5-year outcomes. Results. Overall, data of 2966 women, affected by high-grade cervical dysplasia were reviewed. The study population included 1478 (85%) and 260 (15%) women affected by HR-HPV-positive and HR-HPV-negative high-grade cervical dysplasia. The prevalence of CIN2 and CIN3 among the HR-HPV-positive and-negative cohort was similar (p = 0.315). Patients with HR-HPV-positive high-grade cervical dysplasia were at higher risk of 5-year recurrence (after primary conization) that HR-HPV-negative patients (p < 0.001, log-rank test). Via multi-variate analysis, HR-HPV-negative women were at low risk of recurrence (HR: 1.69 (95%CI: 1.05, 4.80); p = 0.018, Cox Hazard model). A propensity-score matched comparison was carried out in order to reduce biases that are related to the retrospective study design. In comparison to HR-HPV-negative patients, thosewith HR-HPV-positive CIN3 was associate with a 8-fold increase in the risk of recurrence (p < 0.001, log-rank test). Conclusions. HR-HPV-negative high-grade cervical dysplasia is not uncommon, accounting for 15% of our study population. Those patients experience more favorable outcomes than patients with documented HR-HPV infection(s). Further prospective studies are needed to corroborate our data. (c) 2021 Elsevier Inc. All rights reserved.

引用

页码：173 / 178

页数：6

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