Host and viral factors in relation to clearance of human papillomavirus infection: A cohort study in Taiwan
Chyong‐Huey LaiAngel ChaoChee‐Jen ChangFang‐Yu ChaoHuei‐Jean HuangSwei HsuehCheng‐Tao LinHui‐Hsin ChengChu‐Chun HuangJung‐Erh YangTzu‐I WuHung‐Hsueh ChouTing‐Chang Chang
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Abstract Human papillomavirus (HPV) persistence is essential for cervical cancer development. We accrued nested‐cohort subjects from a population‐based study to investigate the host and viral factors related to outcome of HPV infection. Women (age ≥ 30 years old) with HPV‐positive but normal cytology and negative colposcopy were invited to participate. After signing informed consent, every participant completed a structured questionnaire and had 6‐monthly follow‐ups of Pap smear, HPV testing and colposcopy. Total and type‐specific HPV clearance rates as well as host and viral factors associated with clearance in 3‐year longitudinal follow‐up were analyzed. Adjusted hazard ratios (HRs) of progression to ≥ cervical intraepithelial neoplasia (CIN) 2 according to baseline HPV of the women with normal cytology were calculated from national registry database. Among the 626 eligible women, 526 (median age 47, 29–75) were enrolled and 412 returned for follow‐up at least once. The median follow‐up of enrolled subjects was 23 months (range 6.8–39). The 3‐year cumulative total HPV clearance rate was 49.0% (95% confidence interval [CI]: 43.3–54.7%). The median 3‐year cumulative type‐specific HPV clearance rate was 50.0% (range 0–100.0%) with a median time to clearance of 12.4 months (6.4–24.5). Older age was associated with significantly decreased total HPV clearance and decreased type‐specific clearance in HPV‐18 and ‐53, while high viral load was associated with decreased total and type‐specific clearance. After adjusting confounding variables, the HR of developing ≥CIN2 in baseline HPV‐positive women was 34.0‐fold (95% CI: 15.5–74.7) as compared to HPV‐negative women. © 2008 Wiley‐Liss, Inc.Cite
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Objective: To study the value of colposcopy in diagnosis of cervial diseases.Methods: 2989 women were examined with optical colposcope at Taian Central Hospital from July 2005 to Oct 2007,of which 766 were given biopsy under colposcope for pathologica analysis.Results: cervical intraepithelial neoplasia(CIN) were diagnosed in the pathology in 362,including 275 CINⅠ,55 CINⅡ,32 CIN III and15 Cervical Cancer,biopsy CIN rate up to 47.25%.86.74% of the patients with CIN were 20~39 years old,93.33% of cervical cancer were the patients aging 30~49,which is a very dangerous age of cervical cancer.30.17% of the total CIN subjects were with low-grade cercix uterierosion,among which CINⅡand CIN III were 29.09% and 31.25% respectively.And 10.49% of the total CIN subjects were with smooth cervices.Conclusion: Colposcope can be used to find CIN at early stage,and provides a key approach to diagnose early cervical cancers and CIN.
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[Objective]To evaluate the significance of colposcopy combined with DNA ploidy analysis in the therapy of the cervical intraepithelial neoplasia (CIN). [Methods]A total of 66 women were enrolled in the study. DNA ploidy of cervical exfoliated cells was measured by flow cytometry. [Results]All cases classified as DNA ploidy of cervical exfoliated cells were diploid, CIN Ⅰ was diagnosed by colposcopy and histopathology . DNA aneuploidy was found in 71.4% of CIN Ⅰ, 100% of CIN Ⅱ and Ⅲ. The coincidental rate between colposcopy and histopathology diagnosis was 80.00% in CIN Ⅰ, 100.00% in CIN Ⅲ. The CIN Ⅱ were diagnosed by colposcopy examination , 44.0% of CIN Ⅰ, 32.0% of CIN Ⅱ and 24.0% of CIN Ⅲ were diagnosed by the final histopathology examinations. [Conclusion]The study showed that using the technique of colposcopy combined with DNA ploidy analysis of cervical exfoliated cell is useful to further assist the diagnosis of cervical malignancies and clinical treatment of the women with CIN Ⅰ/Ⅱ.
Histopathology
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Abstract Forty‐four patients with cervical intraepithelial neoplasia (CIN) II and 31 patients with CIN III were followed up for up to 6 months after cervical cone vaporization with carbon dioxide laser. In addition to colposcopy and pap smear, all patients underwent cervical biopsies as part of their follow‐up. This protocol permitted a diagnosis of persistent disease in the presence of normal colposcopy and pap smear.
Laser vaporization
Carbon dioxide laser
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Objective:Colposcopy of cervical intraepithelial neoplasia (CIN) diagnosis.Methods:From January 2008 to December 2009 in our hospital gynecology clinic by colposcopy and biopsy diagnosis of CIN,followed by cervical loop ex cision procedure LEEP or cervical conization treatment of 124 patients,the clinical A retrospective analysis.Results:Histological diagnosis under colposcopy and cervical loop excision procedure LEEP or cervical conization final diagnosis was 69.35%(86/124),those who do not meet the 30.65%(38/124),which accounted for 7.26% level rise,of which 4 cases diag nosed as invasive cervical cancer,missed diagnosis rate was 3.23%(4/124);level accounted for 23.39% reduction(29/124).Conclusion:Colposcopy in the diagnosis of CIN and early invasive cervical area,has some clinical value,but on the high level of CIN should be combined with LEEP procedure or electric knife cervical conization as a further diagnosis.
Cervical conization
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Objective To investigate the colposcopy in cervical intraepithelial neoplasia CIN diagnosis.Methods In January 2008 to Dec.2008,156 cases of cervical disease patients with concurrent cervical biopsy pathology were analyzed.Results ① colposcopy in the diagnosis of cervical intraepithelial neoplasia the correct rate 97.6%,false-negative rate(missed diagnosis rate) 2.4%,the sensitivity was 100%.② white vinegar,colposcopy and histology of epithelial images compared with the results: CINI 88.3%,CIN Ⅱ 93.3%,CIN Ⅲ 100%.③ of cervical diseases 35～45 years old constitute the largest proportion(48%).Conclusion Colposcopy diagnosis of cervical intraepithelial neoplasia accurate and reliable,especially for CIN early diagnosis,early treatment to reduce the occurrence of cervical cancer has important diagnostic value.
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Objective To study the diagnosis of cervical intraepi th elial neoplasia for correct treatment promptly.Methods To analyze the clinical feature and the result about colposcopy?pathologic diagnosis?HPV infection.Using various therapy to the aptient with cervical intraepithelial ne oplasia(CIN).Results The proprotions of contact bleeding and HPV infection were higher in the patient with CINⅡ and CINⅢ.It was easy to get mis sed diagnosis when making routine cervical scraping smear.The rate of accurate d iagnosis was higher when colposcopy and pathologic diagnosis were used together. Conclusion To raise the rate of precise diagnosis of cervical int raepithelial neoplasia,it is better than colposcopy and pathologic diagnosis wer e used together.
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Cervicitis
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ABSTRACT Objective To determine the value of colposcopic assessment in the follow up of cervical intraepithelial neoplasia (CIN) treated by laser excision. Design Retrospective analysis of case records of women with CIN treated by laser excision over the period 1986 to 1990. Setting A colposcopy clinic in a district general hospital. Subjects Five hundred‐forty consecutive patients with either CIN or microinvasion diagnosed on laser excision specimens. Results Of 452 patients followed up for 10 months, 14 were diagnosed as having persistent CIN. Eleven of these were detected at the first follow up visit at four months using both colposcopic and cytological assessment. Elimination of colposcopic assessment in follow up would have reduced the number detected to five patients. Conclusion For patients undergoing laser excision for CIN involving the endocervical canal, a normal initial, post‐treatment colposcopy is necessary before surveillance may be reduced to cytology alone.
Value (mathematics)
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Objective:To evaluate the clinical value of colposcopy in diagnosis of cervical disease.Methods:The colposcopy results of 736 patients with cervical disease were analyzed.Results:In all patients,124 cases with cervical intraepithelial neoplasia(CIN) 1,34 cases with CIN 2,13 cases with CIN 3,37 cases with cervical disease and 28 cases with papilloma virus(HPV) infection were diagnosed.Conclusions:Colposcopy is a value way in diagnosis of early cervical carcinoma,CIN and HPV infection.
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