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Lower genital tract infection and other factors associated with cervial intraepithelial neoplasia: a hospital-base case-control study
1Gynecological department, The General Hospital of Liuzhou, Liuzhou, Guangxi (China)
*Corresponding Author(s): Yujie Chen E-mail: yujiechen2584@163.com
Aim: To investigate clinical factors, especially pathogenic in the lower genital tract associated with cervical intraepithelial neoplasia (CIN) among women participating in a cervical cancer (CC) screening program in Liuzhou, south of China. Materials and Methods: A hospital-base case-control study for four years was designed. A total of 12,644 outpatients were involved in this study. Clinical characters were recorded and samples of the cervical secretion were obtained to detect Chlamydia trachomatis (CT), high-risk human papillomavirus (HR-HPV), low-risk HPV (LR-HPV), Neisseria gonorrhoeae (NG), and Ureaplasma urealyticum (UU). Logistic regression models were conducted to investigate the association between the factors and CIN. Results: There were 260 CIN patients of all included cases (2.06%). HR-HPV (OR=18.27, 95%CI 13.89-24.04), CT infection (OR=2.31 95%CI 1.70-3.13), numbers of pregnancy (OR=1.42, 95%CI 1.11-1.83), and older age (OR=1.59, 95%CI 1.16-2.19) were associated with CIN. The prevalence of CIN in patient group HR-HPV(+), CT(+), HR-HPV(+), CT(-); HR-HPV(-), CT(+); HR-HPV(-), and CT(-) was 18.00%, 10.26%, 1.97%, and 0.48%, respectively. Women both HR-HPV and CT positive had a significantly higher susceptibility to CIN (p < 0.001). Conclusion: Age and gravity might be risk factors of CIN. HR-HPV and CT play important roles in cervical carcinogenesis. Co-infection of HR-HPV, and CT might increase the risk of CIN.
Cervical intraepithelial neoplasia (CIN); Chlamydia trachomatis (CT); High risk human-papillomavirus (HR-HPV); Risk factor.
Yujie Chen,Jing Chen,Lan Yang,Yanming Jiang,Li Li,Wenjuan Yi,Lifang Lan,Liuhong Zhang. Lower genital tract infection and other factors associated with cervial intraepithelial neoplasia: a hospital-base case-control study. European Journal of Gynaecological Oncology. 2018. 39(5);795-799.
[1] Ferlay J., Shin H.R., Bray F., Forman D., Mathers C., Parkin D.M.: “Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008”. Int. J. Cancer., 2010, 127, 2893.
[2] Grizzle W.E., Srivastava S., Manne U.: “The biology of incipient, pre-invasive or intraepithelial neoplasia”. Cancer Biomark., 2010, 9, 21.
[3] Sreedevi A., Javed R., Dinesh A.: “Epidemiology of cervical cancer with special focus on India”. Int. J. Womens Health, 2015, 7, 405.
[4] Soohoo M., Blas M., Byraiah G., Carcamo C., Brown B.: “Cervical HPV Infection in Female Sex Workers: A Global Perspective”. Open AIDS J., 2013, 7, 58.
[5] Malogajski J., Brankovic I., Verweij S.P., Ambrosino E., van Agtmael M.A., Brand A., et al.: “Translational potential into health care of basic genomic and genetic findings for human immunodeficiency virus, Chlamydia trachomatis, and human papilloma virus”. Biomed. Res. Int., 2013, 2013, 892106
[6] Gillet E., Meys J.F., Verstraelen H., Verhelst R., De Sutter P., Temmerman M., et al.: “Association between bacterial vaginosis and cervical intraepithelial neoplasia: systematic review and meta-analysis”. PLos One, 2012, 7, e45201.
[7] Oakeshott P., Aghaizu A., Reid F., Howell-Jones R., Hay P.E., Sadiq S.T., et al.: “Frequency and risk factors for prevalent, incident, and persistent genital carcinogenic human papillomavirus infection in sexually active women: community based cohort study”. BMJ, 2012, 344, 1.
[8] Roura E., Castellsagué X., Pawlita M., Travier N., Waterboer T., Margall N., et al.: “Smoking as a major risk factor for cervical cancer and pre-cancer: results from the EPIC cohort”. Int. J. Cancer, 2014, 135, 453.
[9] Gaydos C., Hardick J.: “Point of care diagnostics for sexually transmitted infections: perspectives and advances”. Expert Rev. Anti. Infect. Ther., 2014, 12, 657.
[10] Peterman T.A., Newman D.R., Torrone E., Schmitt K., Shiver S.: “Cumulative risk of chlamydial infection among young women in Florida, 2000-2011”. J. Adolesc. Health, 2014, 55, 241.
[11] Thulaseedharan J.V., Malila N., Hakama M., Esmy P.O., Cheriyan M., Swaminathan R., et al.: “Socio demographic and reproductive risk factors for cervical cancer—a large prospective cohort study from rural India”. Asian Pac. J. Cancer Prev., 2012, 13, 2991.
[12] Ibrahim A., Rasch V., Pukkala E., Aro A.R.: “Predictors of cervical cancer being at an advanced stage at diagnosis in Sudan”. Int. J. Womens Health, 2011, 3, 385.
[13] Thuler L.C., de Aguiar S.S., Bergmann A.: “Determinants of late stage diagnosis of cervical cancer in Brazil”. Rev. Bras. Ginecol. Obstet., 2014, 36, 237.
[14] Jensen K.E., Schmiedel S., Norrild B.: “Parity as a cofactor for highgrade cervical disease among women with persistent human papillomavirus infection: a 13-year follow-up”. Br. J. Cancer, 2013, 108, 234.
[15] Tao L., Han L., Li X., Gao Q., Pan L., Wu L., et al.: “Prevalence and risk factors for cervical neoplasia: a cervical cancer screening program in Beijing”. BMC Public Health, 2014, 14, 1185.
[16] Moscicki A.B., Ma Y., Wibbelsman C., Powers A., Farhat S., Shiboski S.: “Rate of and risks for regression of cervical intraepithelial neoplasia 2 in adolescents and young women”. Obstet. Gynecol., 2010, 116, 1373.
[17] Carne C.A., Gibbs J., Delaney A., Sonnex C., Verlander N.Q., Smielewska A., et al.: “Prevalence, clinical features and quantification of genital non-viral infections”. Int. J. STD. AIDS, 2013, 24, 273.
[18] Mendoza L., Mongelos P., Paez M., Castro A., Rodriguez-Riveros I., Gimenez G., et al.: “Human papillomavirus and other genital infections in indigenous women from Paraguay: a cross-sectional analytical study”. BMC Infect. Dis., 2013, 13, 531.
[19] Zheng M.Y., Zhao H.L., Di J.P., Lin G., Lin Y., Lin X., et al.: “Association of human papillomavirus infection with other microbial pathogens in gynecology”. Zhonghua Fu Chan Ke Za Zhi, 2010, 45, 424.
[20] Caussy D., Marrett L.D., Worth A.J., McBride M., Rawls W.E.: “Human papillomavirus and cervical intraepithelial neoplasia in women who subsequently had invasive cancer”. CMAJ, 1990, 142, 311d.
[21] Nonnenmacher B., Hubbert N.L., Kirnbauer R., Shah K.V., Muñoz N., Bosch F.X., et al.: “Serologic response to human papillomavirus type 16 (HPV-16) virus-like particles in HPV-16 DNA-positive invasive cervical cancer and cervical intraepithelial neoplasia grade III patients and controls from Colombia and Spain”. J. Infect. Dis., 1995, 172, 19s.
[22] Kim J., Kim B.K., Lee C.H.: “Human papillomavirus genotypes and cofactors causing cervical intraepithelial neoplasia and cervical cancer in Korean women”. Int. J. Gynecol. Cancer., 2012, 22, 1570.
[23] Spinillo A, Gardella B, Roccio M, Alberizzi P, Cesari S, Patrizia M, et al: “Multiple human papillomavirus infection with or without type 16 and risk of cervical intraepithelial neoplasia among women with cervical cytological abnormalities”. Cancer Causes Control. 2014; 25(12):1669-1676d.
[24] Arnheim Dahlström L., Andersson K., Luostarinen T., Thoresen S., Ögmundsdottír H., Tryggvadottír L., et al.: “Prospective seroepidemiologic study of human papillomavirus and other risk factors in cervical cancer”. Cancer Epidemiol. Biomarkers Prev., 2011, 20, 2541.
[25] Akande V., Turner C., Horner P., Horne A., Pacey A.: “Impact of Chlamydia trachomatis in the reproductive setting: British Fertility Society Guidelines for practice”. Hum. Fertil. (Camb.), 2010, 13, 115.
[26] Paavonen J.: “Chlamydia trachomatis infections of the female genital tract: state of the art”. Ann. Med., 2012, 44, 18.
[27] Newman L., Rowley J., Vander Hoorn S.,Wijesooriya N.S., Unemo M., Low N., et al.: “Global Estimates of the Prevalence and Incidence of Four Curable Sexually Transmitted Infections in 2012 Based on Systematic Review and Global Reporting”. PLoS One. 2015, 10, e0143304.
[28] Spaulding A.C., Miller J., Trigg B.G., Braverman P., Lincoln T., Reams P.N., et al.: “Screening for sexually transmitted diseases in short-term correctional institutions: summary of evidence reviewed for the 2010 Centers for Disease Control and Prevention Sexually Transmitted Diseases Treatment Guidelines”. Sex Transm Dis., 2013, 40, 679.
[29] Simonetti A.C., Melo J.H., de Souza P.R., Bruneska D., de Lima Filho J.L.: “Immunological’s host profile for HPV and Chlamydia trachomatis, a cervical cancer cofactor”. Microbes Infect., 2009, 11, 435.
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