Predicting the progression of cervical precursor lesions by human papillomavirus genotyping: A prospective cohort study

Koji Matsumoto, Akinori Oki, Reiko Furuta, Hiroo Maeda, Toshiharu Yasugi, Naoyoshi Takatsuka, Akira Mitsuhashi, Takuma Fujii, Yasuo Hirai, Tsuyoshi Iwasaka, Nobuo Yaegashi, Yoh Watanabe, Yutaka Nagai, Tomoyuki Kitagawa, Hiroyuki Yoshikawa

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Abstract

Only a subset of cervical precursor lesions progress to cervical cancer and because of the lack of the predictive markers, it cannot be ascertained which lesions will progress or not. To estimate the risk of disease progression associated with human papillomavirus (HPV) genotypes, we followed 570 Japanese women with cytological LSIL (low-grade squamous intraepithelial lesion) and histological CIN (cervical intraepithelial neoplasia) grade 1-2 lesions (479 CIN 1; 91 CIN 2) at 3 to 4 month intervals for a mean follow-up period of 39.1 months. At entry, we detected HPV DNA in cervical samples by polymerase chain reaction-based methodology. Over the period of follow-up period, 46 lesions progressed to CIN 3 while 362 regressed to normal cytology. Women with multiple HPV infections were more likely to have persistent lesions (hazard ratio [HR] for regression, 0.65; 95% confidence interval [CI], 0.42-1.02; p = 0.07); however, multiple infections did not increase the risk of progression (HR for progression, 1.04; 95% CI, 0.37-2.94; p = 0.94). After adjusting for CIN grade and women's age, HRs for progression to CIN 3 (vs. women with low-risk types or negative for HPV DNA) varied markedly by HPV genotype: type 16 (11.1, 95% CI: 1.39-88.3); 18 (14.1, 0.65-306); 31 (24.7, 2.51-243); 33 (20.3, 1.78-231); 35 (13.7, 0.75-251); 52 (11.6, 1.45-93.3); 58 (8.85, 1.01-77.6); other high-risk types (4.04, 0.47-34.7). HPV 45 was not detected in our study subjects. The cumulative probability of CIN 3 within 5 years was 20.5% for HPV 16, 18, 31, 33, 35, 52 and 58; 6.0% for other high-risk types; 1.7% for low-risk types (p = 0.0001). In conclusion, type-specific HPV testing for women with LSIL/CIN 1-2 lesions is useful for identifying populations at increased or decreased risk of disease progression.

Original languageEnglish
Pages (from-to)2898-2910
Number of pages13
JournalInternational Journal of Cancer
Volume128
Issue number12
DOIs
Publication statusPublished - 15-06-2011

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Cervical Intraepithelial Neoplasia
Cohort Studies
Prospective Studies
Human papillomavirus 16
Confidence Intervals
Disease Progression
Genotype
Human papillomavirus 18
Papillomavirus Infections
DNA
Uterine Cervical Neoplasms
Cell Biology
Polymerase Chain Reaction
Infection

All Science Journal Classification (ASJC) codes

  • Oncology
  • Cancer Research

Cite this

Matsumoto, K., Oki, A., Furuta, R., Maeda, H., Yasugi, T., Takatsuka, N., ... Yoshikawa, H. (2011). Predicting the progression of cervical precursor lesions by human papillomavirus genotyping: A prospective cohort study. International Journal of Cancer, 128(12), 2898-2910. https://doi.org/10.1002/ijc.25630
Matsumoto, Koji ; Oki, Akinori ; Furuta, Reiko ; Maeda, Hiroo ; Yasugi, Toshiharu ; Takatsuka, Naoyoshi ; Mitsuhashi, Akira ; Fujii, Takuma ; Hirai, Yasuo ; Iwasaka, Tsuyoshi ; Yaegashi, Nobuo ; Watanabe, Yoh ; Nagai, Yutaka ; Kitagawa, Tomoyuki ; Yoshikawa, Hiroyuki. / Predicting the progression of cervical precursor lesions by human papillomavirus genotyping : A prospective cohort study. In: International Journal of Cancer. 2011 ; Vol. 128, No. 12. pp. 2898-2910.
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Matsumoto, K, Oki, A, Furuta, R, Maeda, H, Yasugi, T, Takatsuka, N, Mitsuhashi, A, Fujii, T, Hirai, Y, Iwasaka, T, Yaegashi, N, Watanabe, Y, Nagai, Y, Kitagawa, T & Yoshikawa, H 2011, 'Predicting the progression of cervical precursor lesions by human papillomavirus genotyping: A prospective cohort study', International Journal of Cancer, vol. 128, no. 12, pp. 2898-2910. https://doi.org/10.1002/ijc.25630

Predicting the progression of cervical precursor lesions by human papillomavirus genotyping : A prospective cohort study. / Matsumoto, Koji; Oki, Akinori; Furuta, Reiko; Maeda, Hiroo; Yasugi, Toshiharu; Takatsuka, Naoyoshi; Mitsuhashi, Akira; Fujii, Takuma; Hirai, Yasuo; Iwasaka, Tsuyoshi; Yaegashi, Nobuo; Watanabe, Yoh; Nagai, Yutaka; Kitagawa, Tomoyuki; Yoshikawa, Hiroyuki.

In: International Journal of Cancer, Vol. 128, No. 12, 15.06.2011, p. 2898-2910.

Research output: Contribution to journalArticle

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AU - Matsumoto, Koji

AU - Oki, Akinori

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AU - Maeda, Hiroo

AU - Yasugi, Toshiharu

AU - Takatsuka, Naoyoshi

AU - Mitsuhashi, Akira

AU - Fujii, Takuma

AU - Hirai, Yasuo

AU - Iwasaka, Tsuyoshi

AU - Yaegashi, Nobuo

AU - Watanabe, Yoh

AU - Nagai, Yutaka

AU - Kitagawa, Tomoyuki

AU - Yoshikawa, Hiroyuki

PY - 2011/6/15

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N2 - Only a subset of cervical precursor lesions progress to cervical cancer and because of the lack of the predictive markers, it cannot be ascertained which lesions will progress or not. To estimate the risk of disease progression associated with human papillomavirus (HPV) genotypes, we followed 570 Japanese women with cytological LSIL (low-grade squamous intraepithelial lesion) and histological CIN (cervical intraepithelial neoplasia) grade 1-2 lesions (479 CIN 1; 91 CIN 2) at 3 to 4 month intervals for a mean follow-up period of 39.1 months. At entry, we detected HPV DNA in cervical samples by polymerase chain reaction-based methodology. Over the period of follow-up period, 46 lesions progressed to CIN 3 while 362 regressed to normal cytology. Women with multiple HPV infections were more likely to have persistent lesions (hazard ratio [HR] for regression, 0.65; 95% confidence interval [CI], 0.42-1.02; p = 0.07); however, multiple infections did not increase the risk of progression (HR for progression, 1.04; 95% CI, 0.37-2.94; p = 0.94). After adjusting for CIN grade and women's age, HRs for progression to CIN 3 (vs. women with low-risk types or negative for HPV DNA) varied markedly by HPV genotype: type 16 (11.1, 95% CI: 1.39-88.3); 18 (14.1, 0.65-306); 31 (24.7, 2.51-243); 33 (20.3, 1.78-231); 35 (13.7, 0.75-251); 52 (11.6, 1.45-93.3); 58 (8.85, 1.01-77.6); other high-risk types (4.04, 0.47-34.7). HPV 45 was not detected in our study subjects. The cumulative probability of CIN 3 within 5 years was 20.5% for HPV 16, 18, 31, 33, 35, 52 and 58; 6.0% for other high-risk types; 1.7% for low-risk types (p = 0.0001). In conclusion, type-specific HPV testing for women with LSIL/CIN 1-2 lesions is useful for identifying populations at increased or decreased risk of disease progression.

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