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Risk of cervical intraepithelial neoplasia grade 2 or worse after conization in relation to HPV vaccination status.
锥切术后宫颈上皮内瘤变 2 级或更差的风险与 HPV 疫苗接种状态的关系。
HPV vaccination cervical cancer cervical neoplasia conization prospective cohort study
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摘要

Human papillomavirus (HPV) is essential for developing cervical cancer and precancerous lesions. Currently, three vaccines are available, which are effective as prophylaxis against HPV infection, however, limited knowledge exists about the possible effect of vaccinating women treated with conization to prevent recurrence. The aim of our study was to examine the risk of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after conization according to HPV vaccination status. Using Danish nationwide registries, we identified women diagnosed with CIN3 on the cone (2006-2012) and their HPV vaccination status. Vaccinees were defined as women vaccinated between 3 months before until 1 year after conization. The women were followed from 1 year after conization until diagnosis of CIN2+, conization, death, emigration or end of follow-up. Cox proportional hazard regression was used to estimate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) of CIN2+ comparing vaccinees with nonvaccinees. The HR was adjusted for age, histology on cone, education, year of conization, repeat conizations and CIN2+ lesions between conization and start of follow-up. Altogether 17,128 women were included (2,074 vaccinees). There was a statistically nonsignificant lower risk of CIN2+ among vaccinees (HRadjusted = 0.86, 95% CI: 0.67-1.09). Women vaccinated 0-3 months before tended to have a slightly lower HR of CIN2+ (HRadjusted = 0.77, 95% CI: 0.45-1.32) than women vaccinated 0-12 months after conization (HRadjusted = 0.88, 95% CI: 0.67-1.14), although not statistically significantly different. Our results add to the current knowledge about the potential clinical effect of vaccination as an adjunct to conization of high-grade cervical neoplasia to decrease risk of recurrence.

译文

人乳头瘤病毒 (Human papillomavirus,HPV) 对宫颈癌和癌前病变的发展至关重要。目前,有三种疫苗可用于预防人乳头状瘤病毒感染,然而,关于给接受锥切治疗的妇女接种疫苗以预防复发的可能效果的知识有限。我们研究的目的是根据 HPV 疫苗接种状态检查锥切术后宫颈上皮内瘤变 2 级或更糟 (CIN2) 的风险。使用丹麦全国注册,我们确定了被诊断为锥上 CIN3 的女性 (2006-2012) 及其人类乳头瘤病毒疫苗接种状态。疫苗被定义为在锥切手术前 3 个月至术后 1 年接种疫苗的女性。从锥切术后 1 年开始对这些妇女进行随访,直到诊断为 CIN2 、锥切、死亡、移民或随访结束。使用 Cox 比例风险回归来估计 CIN2 的风险比 (HRs) 和相应的 95% 置信区间 (CIs),比较疫苗和非疫苗。在锥切和开始随访期间,根据年龄、锥切组织学、教育程度、锥切年份、重复锥切和 CIN2 病变调整 HR。总共包括 17,128 名妇女 (2,074 名接种疫苗)。在疫苗组中,CIN2 的风险在统计学上没有显著降低 (HRadjusted = 0.86,95% CI: 0.67-1.09)。在锥切术后 (HRadjusted = 0.77,95% CI: 0.45-1.32) 后 0-3 个月接种疫苗的女性比 0-3 个月接种疫苗的女性有更低的 CIN2 HR (HRadjusted = 0.88, 95% CI: 0.67-1.14),虽然没有统计学上的显著差异。我们的研究结果增加了目前关于疫苗接种作为高级宫颈瘤变锥切辅助物以降低复发风险的潜在临床效果的知识。

intraepithelial neoplasia

肿瘤 癌前病变 疾病
概述  :  

上皮内瘤变(IN)和异型增生是同义词;是指基底膜以上上皮的一种非浸润性肿瘤性改变,属于癌前病变,通常表现为组织结构和细胞学存在改变,这些改变被发现可以反映出那些能够引发浸润性癌的潜在分子学异常。病变具有基因的克隆性转变,容易发展为浸润和转移。上皮内瘤变的类型以及形态学特征与这些浸润性肿瘤的前驱病变相关,每个器官各不相同。上皮内瘤变定义的关键在于,所有病变均具有可辨识的形态,具有恶变倾向且无浸润。1960年Richard首次将上皮内瘤变这一名词用于子宫颈黏膜鳞状上皮的癌前变化,它的正确涵义是强

Intraepithelial   /'intrə,epi'θi:liəl/

释    义   adj. 上皮内的

例    句   To study the expression of proliferating cell nuclear antigen(PCNA) and explore whether cell proliferation play an important role in the tissue of prostate intraepithelial neoplasia(PIN). 研究细胞增殖核抗原(PCNA)在前列腺上皮内瘤(PIN)组织中的表达,探讨细胞增殖在前列腺肿瘤形成过程中的作用。

 

Neoplasia   英 /,niːə(ʊ)'pleɪzɪə/   美 /,nio'pleʒɪr/

释    义   n. 瘤形成

例    句   To study the relationship among different types of human papilloma virus, cervical intraepithelial neoplasia and cervical carcinoma. 探讨不同类型人乳头瘤病毒与宫颈上皮内瘤变和宫颈癌的关系。

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