Role of Human Papillomavirus DNA Load in Predicting the Long-term Risk of Cervical Cancer: A 15-Year Prospective Cohort Study in China

Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus virus (HPV)–positive women. A 15-year prospective cohort study in China found that a moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a t...

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Veröffentlicht in:The Journal of infectious diseases 2019-01, Vol.219 (2), p.215-222
Hauptverfasser: Zhao, Xuelian, Zhao, Shuang, Hu, Shangying, Zhao, Kevin, Zhang, Qian, Zhang, Xun, Pan, Qinjing, Zhao, Fanghui
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container_issue 2
container_start_page 215
container_title The Journal of infectious diseases
container_volume 219
creator Zhao, Xuelian
Zhao, Shuang
Hu, Shangying
Zhao, Kevin
Zhang, Qian
Zhang, Xun
Pan, Qinjing
Zhao, Fanghui
description Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus virus (HPV)–positive women. A 15-year prospective cohort study in China found that a moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator. Abstract Background Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus (HPV)–positive women. Methods A total of 1997 women aged 35–45 years in Shanxi, China, were recruited in 1999, and follow-up visits were conducted in 2005, 2010, and 2014. HPV load was measured by the Hybrid Capture 2 assay. Findings were determined by relative light units/cutoff (RLU/CO) and categorized into 4 groups: negative (
doi_str_mv 10.1093/infdis/jiy507
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A 15-year prospective cohort study in China found that a moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator. Abstract Background Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus (HPV)–positive women. Methods A total of 1997 women aged 35–45 years in Shanxi, China, were recruited in 1999, and follow-up visits were conducted in 2005, 2010, and 2014. HPV load was measured by the Hybrid Capture 2 assay. Findings were determined by relative light units/cutoff (RLU/CO) and categorized into 4 groups: negative ( &lt;1.0), low (range, 1.0 to &lt;10.0), moderate (range, 10.0 to &lt;100.0), and high (range, 100.0–∞). Cumulative incidence rates (CIRs) and adjusted hazard ratios (aHRs) for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were calculated for viral load subgroups, using survival analysis. Results Among 1739 women with normal or CIN1 pathological findings at baseline, 15-year CIRs for CIN2+ for those who were HPV negative and those with low, moderate, and high HPV loads groups were 3.1%, 8.4%, 19.9%, and 22.0%, respectively (Ptrend &lt;.001). Compared with women who were negative for HPV from baseline through follow-up, those who had decreasing, increasing, or stable moderate/high loads had aHRs of 9.1, 38.7, or 379.7, respectively, for CIN2+. There was no significant difference between triage based on cytologic findings (for those with atypical squamous cells of undetermined significance or more-severe findings) and that based on a moderate/high HPV load for HPV primary screening (P = .343). Conclusion A moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator for HPV-positive women.</description><identifier>ISSN: 0022-1899</identifier><identifier>EISSN: 1537-6613</identifier><identifier>DOI: 10.1093/infdis/jiy507</identifier><identifier>PMID: 31067317</identifier><language>eng</language><publisher>US: Oxford University Press</publisher><subject>Cervical cancer ; Cervix ; Cohort analysis ; Human papillomavirus ; Squamous cells ; Survival analysis ; VIRUSES</subject><ispartof>The Journal of infectious diseases, 2019-01, Vol.219 (2), p.215-222</ispartof><rights>The Author(s) 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. 2018</rights><rights>The Author(s) 2018. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c415t-2cb87e1f8821bd59072ae2e43c865fce7c86cec3fd383e36032f004c2d56562a3</citedby><cites>FETCH-LOGICAL-c415t-2cb87e1f8821bd59072ae2e43c865fce7c86cec3fd383e36032f004c2d56562a3</cites><orcidid>0000-0001-9294-0005</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,1584,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31067317$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zhao, Xuelian</creatorcontrib><creatorcontrib>Zhao, Shuang</creatorcontrib><creatorcontrib>Hu, Shangying</creatorcontrib><creatorcontrib>Zhao, Kevin</creatorcontrib><creatorcontrib>Zhang, Qian</creatorcontrib><creatorcontrib>Zhang, Xun</creatorcontrib><creatorcontrib>Pan, Qinjing</creatorcontrib><creatorcontrib>Zhao, Fanghui</creatorcontrib><title>Role of Human Papillomavirus DNA Load in Predicting the Long-term Risk of Cervical Cancer: A 15-Year Prospective Cohort Study in China</title><title>The Journal of infectious diseases</title><addtitle>J Infect Dis</addtitle><description>Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus virus (HPV)–positive women. A 15-year prospective cohort study in China found that a moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator. Abstract Background Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus (HPV)–positive women. Methods A total of 1997 women aged 35–45 years in Shanxi, China, were recruited in 1999, and follow-up visits were conducted in 2005, 2010, and 2014. HPV load was measured by the Hybrid Capture 2 assay. Findings were determined by relative light units/cutoff (RLU/CO) and categorized into 4 groups: negative ( &lt;1.0), low (range, 1.0 to &lt;10.0), moderate (range, 10.0 to &lt;100.0), and high (range, 100.0–∞). Cumulative incidence rates (CIRs) and adjusted hazard ratios (aHRs) for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were calculated for viral load subgroups, using survival analysis. Results Among 1739 women with normal or CIN1 pathological findings at baseline, 15-year CIRs for CIN2+ for those who were HPV negative and those with low, moderate, and high HPV loads groups were 3.1%, 8.4%, 19.9%, and 22.0%, respectively (Ptrend &lt;.001). Compared with women who were negative for HPV from baseline through follow-up, those who had decreasing, increasing, or stable moderate/high loads had aHRs of 9.1, 38.7, or 379.7, respectively, for CIN2+. There was no significant difference between triage based on cytologic findings (for those with atypical squamous cells of undetermined significance or more-severe findings) and that based on a moderate/high HPV load for HPV primary screening (P = .343). Conclusion A moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator for HPV-positive women.</description><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Cohort analysis</subject><subject>Human papillomavirus</subject><subject>Squamous cells</subject><subject>Survival analysis</subject><subject>VIRUSES</subject><issn>0022-1899</issn><issn>1537-6613</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><recordid>eNqFkE1LAzEQhoMoWqtHj0rAi5e1-dgk22Opn1BUih48LWl2VlN3NzXZFfz3RrZW8OJpYObh5Z0HoSNKzikZ85FtysKG0dJ-CqK20IAKrhIpKd9GA0IYS2g2Hu-h_RCWhJCUS7WL9jglUnGqBuh57irArsQ3Xa0b_KBXtqpcrT-s7wK-uJvgmdMFtvHkobCmtc0Lbl8hrpuXpAVf47kNb98JU_Af1ugKT3VjwB-gnVJXAQ7Xc4ieri4fpzfJ7P76djqZJSalok2YWWQKaJlljC4KMSaKaWCQcpNJURpQcRowvCx4xoFLwlkZ_zCsEFJIpvkQnfW5K-_eOwhtXttgoKp0A64LOWM8KpAqFRE9_YMuXeeb2C5naaoykkV7kUp6yngXgocyX3lba_-ZU5J_O89753nvPPIn69RuUUOxoX8k_zZ03erfrOMeXYbW-Q3MpFBKMsW_AMlplHs</recordid><startdate>20190107</startdate><enddate>20190107</enddate><creator>Zhao, Xuelian</creator><creator>Zhao, Shuang</creator><creator>Hu, Shangying</creator><creator>Zhao, Kevin</creator><creator>Zhang, Qian</creator><creator>Zhang, Xun</creator><creator>Pan, Qinjing</creator><creator>Zhao, Fanghui</creator><general>Oxford University Press</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-9294-0005</orcidid></search><sort><creationdate>20190107</creationdate><title>Role of Human Papillomavirus DNA Load in Predicting the Long-term Risk of Cervical Cancer</title><author>Zhao, Xuelian ; Zhao, Shuang ; Hu, Shangying ; Zhao, Kevin ; Zhang, Qian ; Zhang, Xun ; Pan, Qinjing ; Zhao, Fanghui</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c415t-2cb87e1f8821bd59072ae2e43c865fce7c86cec3fd383e36032f004c2d56562a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Cohort analysis</topic><topic>Human papillomavirus</topic><topic>Squamous cells</topic><topic>Survival analysis</topic><topic>VIRUSES</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Zhao, Xuelian</creatorcontrib><creatorcontrib>Zhao, Shuang</creatorcontrib><creatorcontrib>Hu, Shangying</creatorcontrib><creatorcontrib>Zhao, Kevin</creatorcontrib><creatorcontrib>Zhang, Qian</creatorcontrib><creatorcontrib>Zhang, Xun</creatorcontrib><creatorcontrib>Pan, Qinjing</creatorcontrib><creatorcontrib>Zhao, Fanghui</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>Nursing &amp; Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>The Journal of infectious diseases</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Zhao, Xuelian</au><au>Zhao, Shuang</au><au>Hu, Shangying</au><au>Zhao, Kevin</au><au>Zhang, Qian</au><au>Zhang, Xun</au><au>Pan, Qinjing</au><au>Zhao, Fanghui</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Role of Human Papillomavirus DNA Load in Predicting the Long-term Risk of Cervical Cancer: A 15-Year Prospective Cohort Study in China</atitle><jtitle>The Journal of infectious diseases</jtitle><addtitle>J Infect Dis</addtitle><date>2019-01-07</date><risdate>2019</risdate><volume>219</volume><issue>2</issue><spage>215</spage><epage>222</epage><pages>215-222</pages><issn>0022-1899</issn><eissn>1537-6613</eissn><abstract>Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus virus (HPV)–positive women. A 15-year prospective cohort study in China found that a moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator. Abstract Background Biomarkers highly predictive of cervical cancer are urgently needed for triaging human papillomavirus (HPV)–positive women. Methods A total of 1997 women aged 35–45 years in Shanxi, China, were recruited in 1999, and follow-up visits were conducted in 2005, 2010, and 2014. HPV load was measured by the Hybrid Capture 2 assay. Findings were determined by relative light units/cutoff (RLU/CO) and categorized into 4 groups: negative ( &lt;1.0), low (range, 1.0 to &lt;10.0), moderate (range, 10.0 to &lt;100.0), and high (range, 100.0–∞). Cumulative incidence rates (CIRs) and adjusted hazard ratios (aHRs) for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) were calculated for viral load subgroups, using survival analysis. Results Among 1739 women with normal or CIN1 pathological findings at baseline, 15-year CIRs for CIN2+ for those who were HPV negative and those with low, moderate, and high HPV loads groups were 3.1%, 8.4%, 19.9%, and 22.0%, respectively (Ptrend &lt;.001). Compared with women who were negative for HPV from baseline through follow-up, those who had decreasing, increasing, or stable moderate/high loads had aHRs of 9.1, 38.7, or 379.7, respectively, for CIN2+. There was no significant difference between triage based on cytologic findings (for those with atypical squamous cells of undetermined significance or more-severe findings) and that based on a moderate/high HPV load for HPV primary screening (P = .343). Conclusion A moderate/high HPV load may accelerate the progression of cervical precancers and potentially could be used as a triage indicator for HPV-positive women.</abstract><cop>US</cop><pub>Oxford University Press</pub><pmid>31067317</pmid><doi>10.1093/infdis/jiy507</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0001-9294-0005</orcidid><oa>free_for_read</oa></addata></record>
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subjects Cervical cancer
Cervix
Cohort analysis
Human papillomavirus
Squamous cells
Survival analysis
VIRUSES
title Role of Human Papillomavirus DNA Load in Predicting the Long-term Risk of Cervical Cancer: A 15-Year Prospective Cohort Study in China
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