Risk factors for cytological progression in HPV 16 infected women with ASC-US or LSIL: The Korean HPV cohor

초록

Objective This study was to identify the risk factors for cytological progression in women with atypical squamous cells ofundetermined 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 HPVcohort study. The cohort recruited women aged 20–60 years with abnormal cervical cytology (ASC-US or LSIL) fromApril 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 thetime of enrollment, 143 women tested positive for HPV 16 (85 single and 58 multiple infections). Cervical cytologyperformed in the HPV 16-positive women showed progression in 27%, no change in 23%, and regression in 50% ofthe women at the six-month follow-up. The progression rate associated with HPV 16 infection was higher than thatwith 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 withincidental or cleared infections (P <0.001). Logisticregression analysis showed a significant relationshipbetween cigarette smoking and cytological progression(RR, 4.15; 95% CI, 1.01–17.00). Conclusion The cytological progression rate in HPV 16-positivewomen with ASC-US or LSIL is higher than that in womeninfected with other HPV types. Additionally, cigarettesmoking may play a role in cytological progression.

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