Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohort

  • So, Kyeong A (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Kim, Seon Ah (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Lee, Yoo Kyung (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Lee, In Ho (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Lee, Ki Heon (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Rhee, Jee Eun (Division of Viral Disease Research Center for Infectious Disease Research, National Institute of Health, Korea Centers for Disease Control and Prevention) ;
  • Kee, Mee Kyung (Division of Viral Disease Research Center for Infectious Disease Research, National Institute of Health, Korea Centers for Disease Control and Prevention) ;
  • Cho, Chi Heum (Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center) ;
  • Hong, Sung Ran (Department of Pathology, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine) ;
  • Hwang, Chang Sun (Human Resource Biobank, Cheil General Hospital and Women's Healthcare Center, Dankook University College of Medicine) ;
  • Jeong, Mi Seon (Laboratory of R&D for Genomics, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University) ;
  • Kim, Ki Tae (Department of Obstetrics and Gynecology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Ki, Moran (Department of Cancer Control and Policy, Graduate School of Cancer Science and Policy, National Cancer Center) ;
  • Hur, Soo Young (Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University) ;
  • Park, Jong Sup (Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, The Catholic University) ;
  • Kim, Tae Jin (Department of Obstetrics and Gynecology, Cheil General Hospital and Women's Healthcare Center, College of Medicine, Dankook University)
  • Received : 2017.11.18
  • Accepted : 2018.03.08
  • Published : 2018.11.15
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Abstract

Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL). Methods We analyzed data from women infected with the human papillomavirus (HPV) who participated in the Korean HPV cohort study. The cohort recruited women aged 20-60 years with abnormal cervical cytology (ASC-US or LSIL) from April 2010. All women were followed-up at every 6-month intervals with cervical cytology and HPV DNA testing. Results Of the 1,158 women included, 654 (56.5%) and 504 (43.5%) women showed ASC-US and LSIL, respectively. At the time of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytology performed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% of the women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than that with infection caused by other HPV types (relative risk [RR], 1.75; 95% confidence interval [CI], 1.08-2.84; P=0.028). The cytological progression rate in women with persistent HPV 16 infection was higher than that in women with incidental or cleared infections (P<0.001). Logistic regression analysis showed a significant relationship between cigarette smoking and cytological progression (RR, 4.15; 95% CI, 1.01-17.00). Conclusion The cytological progression rate in HPV 16-positive women with ASC-US or LSIL is higher than that in women infected with other HPV types. Additionally, cigarette smoking may play a role in cytological progression.

Keywords

Acknowledgement

Supported by : Korea Centers for Disease Control and Prevention

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