1229 women whose treatment was reviewed by the judicial inquiry in 1987–88 were included. Of these, 48 records (4%) could not be located and 47 women (4%) did not meet the inclusion criteria. At histopathological review, a further 71 (6%of 1134) women were excluded because the review diagnosis was not CIN3. We identified outcomes in the remaining 1063 (86%of 1229) women diagnosed with CIN3 at the hospital in 1955–76. In 143 women managed only by punch or wedge biopsy, cumulative incidence of invasive cancer of the cervix or vaginal vault was 31·3%(95%CI 22·7–42·3) at 30 years, and 50·3%(37·3–64·9) in the subset of 92 such women who had persistent disease within 24 months. However, cancer risk at 30 years was only 0·7%(0·3–1·9) in 593 women whose initial treatment was deemed adequate or probably adequate, and whose treatment for recurrent disease was conventional.
This study provides the most valid direct estimates yet available of the rate of progression from CIN3 to invasive cancer. Women with untreated CIN3 are at high risk of cervical cancer, whereas the risk is very low in women treated conventionally throughout.
Cancer Society of New Zealand, Wellington, New Zealand.
c="/scidirimg/jrn_nsub.gif" alt="You are not entitled to access the full text of this document" title="You are not entitled to access the full text of this document" width=12 height=14"> ciencedirect.com/science?_ob=ArticleURL&_udi=B6VJV-4K4WN3W-6&_user=10&_coverDate=08%2F31%2F2006&_rdoc=1&_fmt=high&_orig=article&_cdi=6104&_sort=v&_docanchor=&view=c&_ct=116&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=7381da229aa1ae7835f297e5bd0348fb">Detection of HPV in Norwegian cervical biopsy specimens with type Journal of Clinical Virology, Volume 36, Issue 4, August 2006, Pages 277-282 Christine C. Roberts, Amha S. Tadesse, Jeffrey Sands, Tore Halvorsen, Timothy L. Schofield, Are Dalen, Finn Egil Skjeldestad, Kathrin U. Jansen Abstract class="mlktScroll"> class="h4">BackgroundAlthough the association of HPV16 and HPV18 DNA with cervical cancers has been well studied, the prevalence of these types in high-grade cervical intraepithelial neoplasias (CIN2/3) may differ from the prevalence found in cervical cancer specimens.class="h4">ObjectiveTo determine the prevalence of specific HPV types found in high-grade CIN2/3 biopsy samples. class="h4">Study designOne thousand eight hundred and forty-eight cervical biopsy specimens were obtained from Norwegian women. HPV16 and HPV18 type and gene-specific PCR assays were performed amplifying a portion of the E6, E7 and L1 genes. In addition, the reverse line blot assay was performed on a subset of specimens, in which a portion of L1 was amplified and hybridized to strips coated with complimentary HPV sequences. class="h4">ResultsThe prevalences of HPV16 and HPV18 in the 1848 biopsy cohort were 32.3%and 6.0%, respectively. HPV16 was detected in 47.5%and HPV18 in 5.9%of diagnosed CIN2/3 specimens. Approximately 12%of the CIN2/3 specimens contained two HPV types and 2.5%contained three HPV types. class="h4">ConclusionsThe prevalence of HPV16 increases from grades CIN1 to CIN2 to CIN3. The prevalence of HPV18 did not change significantly with increasing CIN grade. The majority of infections diagnosed as CIN2/3 contained a single HPV type. The type-specific PCR assay had increased detection sensitivity over the reverse line blot assay. ciencedirect.com/science?_ob=MImg&_imagekey=B6VJV-4K4WN3W-6-1&_cdi=6104&_user=10&_orig=article&_coverDate=08%2F31%2F2006&_sk=999639995&view=c&wchp=dGLbVzz-zSkWb&md5=3951a1bf0e1d2a8ef752a51a020d6dd7&ie=/sdarticle.pdf">cal-align:absmiddle;" border="0" src="http://www.sciencedirect.com/scidirimg/icon_pdf.gif" alt=""> Purchase PDF (112 K) |
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Heterogeneity in CIN3 diagnosis
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