Retrospective Investigation of Human Papillomavirus Cervical Infection and Lymphoma Incidence: A Clinical and Pathological Evaluation.

IF 2 4区 医学 Q2 OBSTETRICS & GYNECOLOGY Gynecologic and Obstetric Investigation Pub Date : 2024-01-01 Epub Date: 2024-01-23 DOI:10.1159/000535592
Barbara Gardella, Mattia Dominoni, Marianna Francesca Pasquali, Manuel Gotti, Sara Fraticelli, Marco Lucioni, Stefania Cesari, Giacomo Fiandrino, Annalisa De Silvestri, Caterina Zerbi, Tanja Lazic, Luca Arcaini, Marco Paulli, Arsenio Spinillo
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引用次数: 0

Abstract

Objective: Human papillomavirus (HPV) persistence is considered the main risk factor for neoplastic progression, and evidence suggests that regulatory T cells play an important role in the failure of viral elimination. Regulatory T cells may be involved in maintaining a microenvironment favourable for viral persistence and neoplasticity, through a deregulation of the local immune response. The association between altered immune function and the development of chronic infections, cancer (solid and haematological), and autoimmune diseases is documented in the literature. The purpose of this retrospective analysis was to evaluate the possible correlation between HPV cervical infection and lymphoma incidence in women attending colposcopy due to an abnormal Pap smear during a period of 15 years.

Design: This is a cross-sectional study.

Participants: We investigated retrospectively the incidence of haematological diseases in women aged 21-84 with an abnormal Pap smear who referred to our centre between 2004 and 2019.

Setting: This study was conducted at the university hospital.

Methods: In our analysis, we included women with diagnoses of HL and NHL after the detection of abnormal Pap smears and HPV infections. We excluded patients with a diagnosis of lymphoma preceding the date of the abnormal Pap smear and HPV test.

Results: We divided the patients into two groups in order to analyse the standard incidence ratio (SIR): HL patients (19/7,064, 0.26%) and NHL patients (22/7,064, 0.31%). In our sample, we reported a significant risk of developing lymphoma compared to the general population, both for HL and NHL disease, at age <45 years. Regarding HL, the SIR of disease in women <45 years was 4.886 (95% CI 2.775-9.6029) and in women between 45 and 59 years was 2.612 (95% CI 0.96-7.108804). On the other hand, for NHL in women <45 years, we reported an SIR of about 3.007 (95%, CI 1.273-7.101575), in women aged 45-59 years, the SIR was 4.291 (95% CI 2.444-7.534399), and in women aged 60-74 years, the SIR was 3.283 (95% CI 1.054-10.22303).

Limitations: This retrospective analysis was conducted in a single centre in Northern Italy and did not consider all interregional differences existing in the country in terms of HPV genotypes, ethnicity, and population characteristics. Regarding the analysis of SIR for HL and NHL, we did not divide the disease into subtypes because of the small sample of cases. Finally, we considered in our analysis only women with an abnormal Pap smear and not the general population.

Conclusions: Women with chronic and persistent HPV infections may have a higher relative risk of developing lymphoma. This possible association may be caused by the deregulation of the immune system response against HPV and the failure of viral clearance, especially in younger women.

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人类乳头瘤病毒宫颈感染与淋巴瘤发病率的回顾性调查:临床与病理评估。
目的:人类乳头瘤病毒(HPV)的持续存在被认为是肿瘤进展的主要风险因素,有证据表明,调节性 T 细胞在病毒清除失败中扮演着重要角色。调节性 T 细胞可能通过对局部免疫反应的调节,参与维持有利于病毒持续存在和瘤形成的微环境。文献记载了免疫功能改变与慢性感染、癌症(实体肿瘤和血液肿瘤)以及自身免疫性疾病的发生之间的联系。这项回顾性分析的目的是评估 15 年间因巴氏涂片异常而接受阴道镜检查的妇女中 HPV 宫颈感染与淋巴瘤发病率之间可能存在的相关性:我们回顾性地调查了2004年至2019年期间因子宫颈抹片检查异常而到我们中心就诊的21-84岁女性中血液病的发病率:地点:大学医院在分析中,我们纳入了在检测到巴氏涂片异常和人乳头瘤病毒感染后诊断为HL和NHL的女性。我们排除了在巴氏涂片和人乳头瘤病毒检测异常日期之前诊断出淋巴瘤的患者。结果 为了分析标准发病率(SIR),我们将患者分为两组:HL 患者(19/7064,0.26%)和 NHL 患者(22/7064,0.31%)。在我们的样本中,与普通人群相比,年龄小于 45 岁的 HL 和 NHL 患者罹患淋巴瘤的风险较高。关于 HL,女性患病的 SIR
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来源期刊
CiteScore
4.20
自引率
4.80%
发文量
44
审稿时长
6-12 weeks
期刊介绍: This journal covers the most active and promising areas of current research in gynecology and obstetrics. Invited, well-referenced reviews by noted experts keep readers in touch with the general framework and direction of international study. Original papers report selected experimental and clinical investigations in all fields related to gynecology, obstetrics and reproduction. Short communications are published to allow immediate discussion of new data. The international and interdisciplinary character of this periodical provides an avenue to less accessible sources and to worldwide research for investigators and practitioners.
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