Cent Eur J Public Health 2008, 16(Supplement):S45-S46

Comparison of Clinical Potential of Vaccine-Related Types (16-18) and Other HR-HPV Types in Follow-up of Women with Squamous Intraepithelial Lesions of the Uterine Cervix

Carmine Carriero¹, Valentina Lezzi¹, Tiziana Mancini¹, Maria Chironna², Michele Quarto², Giuseppe Putignano¹

¹ Dept. Gynecology, Obstetrics and Neonatology - University of Bari,Bari, Italy

² Hygiene Section, Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy

Background: Since the introduction of prophylactic HPV vaccines, the issue of prevalence and malignant potential of different high risk-HPV types (in particular 16 and 18) becomes really relevant.

Material and Methods: In our Colposcopy clinic a database of patients with squamous intraepithelial lesions of the lower genital tract includes all clinical data, collected in controls during follow-up, together with HPV-DNA type definition. We divided all patients eligible for the study (186) in two cohorts, according to the presence of HPV 16 or 18 DNA-type ("16-18" group) or the presence of other HR-HPV DNA types ("Others" group). The population included 114 women with low-grade SIL followed without treatment for a period of 12-36 months, and 72 patients with high-grade SIL followed after treatment for a similar period. Treatment for cervical lesion was excisional: loop excision by radiosurgery or cold knife conization. Follow-up was conducted with cytology and colposcopy 6-monthly.

Results: The prevalence of low-risk (HPV-CIN1) and high-risk (CIN2-3) lesions were not significantly different in the two cohorts. Considering the Kaplan-Meyer curves of progression/recurrence probability during follow-up, having as time-0 treatment (in treated cases) or diagnosis (in untreated cases): with Mantel-Haenzsel log rank test no significant differences in recurrence/progression potential were found in the two cohorts.

Conclusions: We conclude that there is no evidence that 16-18 HPV types have higher potential of progression or recurrence than other HR-HPV types, the latter representing in our series about 38 % of all cases. Vaccine is probably going to revolutionize the policy of cervical cancer secondary prevention, based on cytological screening, but the importance of rarer high-risk HPV types must not be underestimated. In fact, we hope that cervical prevention would remain on three fundamental mainstays: cytology, HPV-DNA (or mRNA) test, vaccine. Moreover, we look forward to new advances, such as second generation prophylactic vaccines and therapeutic vaccines.

Zveřejněno: 1. duben 2008  Zobrazit citaci