PMID- 15458897
OWN - NLM
STAT- MEDLINE
DCOM- 20041116
LR  - 20221207
IS  - 0029-7844 (Print)
IS  - 0029-7844 (Linking)
VI  - 104
IP  - 4
DP  - 2004 Oct
TI  - Regression of low-grade cervical intraepithelial neoplasia in patients with 
      HLA-DRB1*13 genotype.
PG  - 751-5
AB  - OBJECTIVE: The human leukocyte antigen (HLA)-DRB1*13 allele frequency is lower in 
      women with cervical carcinoma than in the general population, suggesting that 
      this allele could exert a protective effect against progression of cervical 
      intraepithelial neoplasia (CIN) associated with human papillomaviruses (HPV). To 
      test this hypothesis, we designed a prospective study of low-grade CIN (CIN1) and 
      analyzed the probability of regression of these lesions according to HLA-DR and 
      HPV status. METHODS: The study sample was composed of 86 women with CIN1 who 
      agreed to regular colposcopic follow-up and no immediate treatment. Biopsy 
      specimens were taken under colposcopy for histology and for the determination of 
      HPV and HLA status. Cases were classified into 3 groups: CIN1 regression, 
      persistence for at least 12 months, or progression to CIN2 or 3. RESULTS: The 
      rate of spontaneous regression (95% confidence interval) at 24 months was 51.6% 
      (39-61.6%) overall compared with 34.7% (13.4-50.8%) in HPV16/18 positive cases 
      and 59.9% (43.7-71.4%) in HPV16/18-negative cases (P =.051). The rate of 
      regression was 71.8% (40.8-86.5%) in patients with HLA-DRB1*13 and 45.9% 
      (31.5-57.2%) in patients with other genotypes (P =.03). Regression reached 90.5% 
      (38.9-98.5%) at 18 months in DRB1*13 patients with HPV16/18-negative-associated 
      CIN (15.1% of the cases). In multivariable analysis, HLA-DRB1*13 allele and 
      HPV16/18-negative status were independently associated with an increased 
      probability for regression (adjusted hazard ratio 2.1 [1.0-4.1] and 2.5 
      [1.2-5.4], respectively). CONCLUSION: A subset of approximately 15% of CIN1 
      highly likely to show spontaneous regression can be defined using 2 biologic 
      parameters that characterize the viral causative agent and the host. LEVEL OF 
      EVIDENCE: II-2
FAU - Sastre-Garau, Xavier
AU  - Sastre-Garau X
AD  - Department of Pathology, Institut Curie, 26 rue d'Ulm, 75231 Paris Cedex, France. 
      xavier.sastre@curie.net
FAU - Cartier, Isabelle
AU  - Cartier I
FAU - Jourdan-Da Silva, Nathalie
AU  - Jourdan-Da Silva N
FAU - De Cremoux, Patricia
AU  - De Cremoux P
FAU - Lepage, Virginia
AU  - Lepage V
FAU - Charron, Dominique
AU  - Charron D
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Obstet Gynecol
JT  - Obstetrics and gynecology
JID - 0401101
RN  - 0 (HLA-DR Antigens)
RN  - 0 (HLA-DRB1 Chains)
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Aged
MH  - Alleles
MH  - Cohort Studies
MH  - Female
MH  - Genotype
MH  - HLA-DR Antigens/*genetics
MH  - HLA-DRB1 Chains
MH  - Humans
MH  - Middle Aged
MH  - Neoplasm Regression, Spontaneous/genetics
MH  - Papillomaviridae/*immunology/isolation & purification
MH  - Prospective Studies
MH  - Uterine Cervical Neoplasms/*immunology/virology
MH  - Uterine Cervical Dysplasia/*immunology/virology
EDAT- 2004/10/02 05:00
MHDA- 2004/11/17 09:00
CRDT- 2004/10/02 05:00
PHST- 2004/10/02 05:00 [pubmed]
PHST- 2004/11/17 09:00 [medline]
PHST- 2004/10/02 05:00 [entrez]
AID - 104/4/751 [pii]
AID - 10.1097/01.AOG.0000139834.84628.61 [doi]
PST - ppublish
SO  - Obstet Gynecol. 2004 Oct;104(4):751-5. doi: 10.1097/01.AOG.0000139834.84628.61.