Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia

被引：39

作者：

Bogani, Giorgio ^{[1
]}

Lalli, Luca ^{[2
]}

Sopracordevole, Francesco ^{[3
]}

Ciavattini, Andrea ^{[4
]}

Ghelardi, Alessandro ^{[5
]}

Simoncini, Tommaso ^{[6
]}

Plotti, Francesco ^{[7
]}

Casarin, Jvan ^{[8
]}

Serati, Maurizio ^{[8
]}

Pinelli, Ciro ^{[9
]}

Bergamini, Alice ^{[10
]}

Gardella, Barbara ^{[11
]}

Dell'Acqua, Andrea ^{[12
]}

Monti, Ermelinda ^{[12
]}

Vercellini, Paolo ^{[12
]}

Palaia, Innocenza ^{[1
]}

Perniola, Giorgia ^{[1
]}

Fischetti, Margherita ^{[1
]}

Santangelo, Giusi ^{[1
]}

Fracassi, Alice ^{[1
]}

D'Ippolito, Giovanni ^{[13
]}

Aguzzoli, Lorenzo ^{[13
]}

Mandato, Vincenzo Dario ^{[13
]}

Giannella, Luca ^{[4
]}

Scaffa, Cono ^{[14
]}

Falcone, Francesca ^{[14
]}

Borghi, Chiara ^{[15
]}

Malzoni, Mario ^{[16
]}

Giannini, Andrea ^{[1
,17
]}

Salerno, Maria Giovanna ^{[17
]}

Liberale, Viola ^{[18
]}

Contino, Biagio ^{[18
]}

Donfrancesco, Cristina ^{[19
]}

Desiato, Michele ^{[19
]}

Perrone, Anna Myriam ^{[20
]}

Dondi, Giulia ^{[20
]}

De Iaco, Pierandrea ^{[20
]}

Ferrero, Simone ^{[21
,22
]}

Sarpietro, Giuseppe ^{[23
]}

Matarazzo, Maria G. ^{[23
]}

Cianci, Antonio ^{[23
]}

Cianci, Stefano ^{[24
]}

Bosio, Sara ^{[25
]}

Ruisi, Simona ^{[25
]}

Mosca, Lavinia ^{[26
]}

Tinelli, Raffaele ^{[27
]}

De Vincenzo, Rosa ^{[28
]}

Zannoni, Gian Franco ^{[28
]}

Ferrandina, Gabriella ^{[28
]}

Petrillo, Marco ^{[29
]}

机构：

[1] Sapienza Univ Rome, Dept Gynecol Obstet & Urol Sci, I-00161 Rome, Italy

[2] Fdn IRCCS Ist Nazl Tumori Milano, Gynecol Oncol Unit, I-20133 Milan, Italy

[3] Ctr Riferimento Oncol, Natl Canc Inst, Gynecol Oncol Unit, Via F Gallini 2, I-33081 Aviano, Italy

[4] Polytech Univ Marche, Gynecol Sect, Womans Hlth Sci Dept, I-60126 Ancona, Italy

[5] Osped Apuane, UOC Ostetricia & Ginecol, Azienda Usl Toscana Nord Ovest, I-54100 Massa, Italy

[6] Univ Pisa, Dept Clin & Expt Med, I-56126 Pisa, Italy

[7] Campus Biomed Univ Rome, Dept Obstet & Gynecol, I-00128 Rome, Italy

[8] Univ Insubria, Filippo Del Ponte Hosp, Dept Obstet & Gynecol, I-21100 Varese, Italy

[9] Osped Circolo Fdn Macchi, I-21100 Varese, Italy

[10] IRCCS Osped San Raffaele, Dept Obstet & Gynecol, I-20100 Milan, Italy

[11] Univ Pavia, IRCCS S Matteo Fdn, Dept Clin Surg Diagnost & Paediat Sci, I-27100 Pavia, Italy

[12] Fdn IRCCS Ca Granda Osped Maggiore Policlin, Gynaecol Unit, I-20122 Milan, Italy

[13] Azienda Unita Sanitaria Locale IRCCS Reggio Emili, Cesare Magati Hosp, Div Obstet & Gynecol, I-42019 Scandiano, Italy

[14] Ist Nazl Tumori IRCCS Fdn G Pascale, Gynecol Oncol Unit, I-80131 Naples, Italy

[15] S Anna Univ Hosp, Dept Obstet & Gynecol, I-44121 Ferrara, Italy

[16] Ctr Adv Endoscop Gynecol Surg, Endoscop Malzoni, I-83100 Avellino, Italy

[17] San Camillo Forlanini Hosp, Obstet & Gynecol Unit, Dept Womans & Childs Hlth, I-00152 Rome, Italy

[18] Osped Maria Vittoria, Dept Obstet & Gynecol, I-10144 Turin, Italy

[19] Osped S Trinita di Sora, Azienda ASL Frosinone, Dept Obstet & Gynecol, I-03039 Sora, Italy

[20] St Orsola Malpighi Hosp, Gynecol Oncol Unit, I-40138 Bologna, Italy

[21] IRCCS Osped Policlin San Martino, Acad Unit Obstet & Gynaecol, I-16132 Genoa, Italy

[22] Univ Genoa, Dept Neurosci Rehabil Ophthalmol Genet Maternal &, I-16132 Genoa, Italy

[23] Univ Catania, Gynecol Clin, Dept Gen Surg & Med Surg Specialties, Via S Sofia 78, I-95124 Catania, Italy

[24] Univ Messina, Dept Gynecol Oncol, Policlin G Martino, I-98122 Messina, Italy

[25] Univ Milan, San Paolo Hosp, I-20142 Milan, Italy

[26] Univ Campania Luigi Vanvitelli, Dept Woman Child & Gen & Specialized Surg, I-80138 Naples, Italy

[27] Valle dItria Hosp, Dept Obstet & Gynecol, Via San Francesco da Paola, I-74015 Taranto, Italy

[28] Fdn Policlin Univ A Gemelli, IRCCS, Dipartimento Salute Donna & Bambino & Salute Pubb, UOC Ginecol Oncol, I-00168 Rome, Italy

[29] Univ Sassari, Gynecol & Obstet Unit, Dept Med Surg & Expt Sci, I-07100 Sassari, Italy

[30] Univ Naples Federico II, Sch Med, Dept Neurosci Reprod Sci & Dent, I-80131 Naples, Italy

[31] Studio Med Muschiato, Loano & Finale Ligure, I-17025 Loano, Italy

[32] GOM Reggio Calabria, Unit Obstet & Gynecol, I-88100 Catanzaro, Italy

[33] Magna Graecia Univ Catanzaro, I-88100 Catanzaro, Italy

来源：

VACCINES | 2022年 / 10卷 / 04期

关键词：

HPV; conization; cervical dysplasia; LEEP; recurrence; INTRAEPITHELIAL NEOPLASIA; HPV; WOMEN; INFECTION; PREVENTION; CONIZATION; RECURRENCE; EXCISION; VACCINE; TRIAL;

D O I：

10.3390/vaccines10040579

中图分类号：

R392 [医学免疫学]; Q939.91 [免疫学];

学科分类号：

100102 ;

摘要：

Background: Cervical dysplasia persistence/recurrence has a great impact on women's health and quality of life. In this study, we investigated whether a prognostic nomogram may improve risk assessment after primary conization. Methods: This is a retrospective multi-institutional study based on charts of consecutive patients undergoing conization between 1 January 2010 and 31 December 2014. A nomogram assessing the importance of different variables was built. A cohort of patients treated between 1 January 2015 and 30 June 2016 was used to validate the nomogram. Results: A total of 2966 patients undergoing primary conization were analyzed. The median (range) patient age was 40 (18-89) years. At 5-year of follow-up, 6% of patients (175/2966) had developed a persistent/recurrent cervical dysplasia. Median (range) recurrence-free survival was 18 (5-52) months. Diagnosis of CIN3, presence of HR-HPV types, positive endocervical margins, HPV persistence, and the omission of HPV vaccination after conization increased significantly and independently of the risk of developing cervical dysplasia persistence/recurrence. A nomogram weighting the impact of all variables was built with a C-Index of 0.809. A dataset of 549 patients was used to validate the nomogram, with a C-index of 0.809. Conclusions: The present nomogram represents a useful tool for counseling women about their risk of persistence/recurrence after primary conization. HPV vaccination after conization is associated with a reduced risk of CIN2+.

引用

页数：11

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