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Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: a prospective cohort study.
Arthritis Care Res (Hoboken) 2011; 63(2):269-76AC

Abstract

OBJECTIVE

We undertook a prospective cohort study to ascertain the risk factors for the development of squamous intraepithelial lesions (SIL) in patients with systemic lupus erythematosus (SLE).

METHODS

One hundred thirty-seven SLE patients with a normal Papanicolaou (Pap) smear at baseline were evaluated at 6-month intervals for up to 3 years. At each visit, a Pap smear, human papillomavirus (HPV) DNA test, and clinical assessment were performed.

RESULTS

Among the 137 patients, there were 12 incident cases (8.8%) of SIL over a median followup duration of 30.7 months (interquartile range 25.5-31.7). Among the 30 patients with HPV infection detectable by DNA testing at baseline, 9 (30%) developed SIL. The independent risk factors for the incident SIL in this group of SLE patients included the use of cyclophosphamide (CYC) ever (odds ratio [OR] 5.6, 95% confidence interval [95% CI] 1.1-29.3; P=0.041) and persistent high-risk HPV infection (OR 26.9, 95% CI 3.2-222.3; P=0.002). The use of baseline HPV testing has a higher sensitivity than abnormal cytology (defined as atypical squamous cells of undetermined significance; 47.7% versus 33.3%) in predicting the development of SIL.

CONCLUSION

Independent risk factors associated with the development of SIL in SLE patients included persistent high-risk HPV infection and the use of CYC. Low-risk patients who receive negative test results on both cervical cytology screening and HPV DNA testing may not need to be rescreened within 3 years.

Authors+Show Affiliations

Department of Medicine and Therapeutics, The Prince of Wales Hospital and The Chinese University of Hong Kong, Hong Kong, China. tamls_813@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

20890985

Citation

Tam, Lai-Shan, et al. "Risk Factors for Squamous Intraepithelial Lesions in Systemic Lupus Erythematosus: a Prospective Cohort Study." Arthritis Care & Research, vol. 63, no. 2, 2011, pp. 269-76.
Tam LS, Chan PK, Ho SC, et al. Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: a prospective cohort study. Arthritis Care Res (Hoboken). 2011;63(2):269-76.
Tam, L. S., Chan, P. K., Ho, S. C., Yu, M. Y., Yim, S. F., Cheung, T. H., ... Li, E. K. (2011). Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: a prospective cohort study. Arthritis Care & Research, 63(2), pp. 269-76. doi:10.1002/acr.20367.
Tam LS, et al. Risk Factors for Squamous Intraepithelial Lesions in Systemic Lupus Erythematosus: a Prospective Cohort Study. Arthritis Care Res (Hoboken). 2011;63(2):269-76. PubMed PMID: 20890985.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Risk factors for squamous intraepithelial lesions in systemic lupus erythematosus: a prospective cohort study. AU - Tam,Lai-Shan, AU - Chan,Paul K S, AU - Ho,Suzanne C, AU - Yu,Mei-Yung, AU - Yim,So-Fan, AU - Cheung,Tak-Hong, AU - Wong,Martin C S, AU - Cheung,Jo L K, AU - Li,Edmund K, PY - 2010/10/5/entrez PY - 2010/10/5/pubmed PY - 2011/3/11/medline SP - 269 EP - 76 JF - Arthritis care & research JO - Arthritis Care Res (Hoboken) VL - 63 IS - 2 N2 - OBJECTIVE: We undertook a prospective cohort study to ascertain the risk factors for the development of squamous intraepithelial lesions (SIL) in patients with systemic lupus erythematosus (SLE). METHODS: One hundred thirty-seven SLE patients with a normal Papanicolaou (Pap) smear at baseline were evaluated at 6-month intervals for up to 3 years. At each visit, a Pap smear, human papillomavirus (HPV) DNA test, and clinical assessment were performed. RESULTS: Among the 137 patients, there were 12 incident cases (8.8%) of SIL over a median followup duration of 30.7 months (interquartile range 25.5-31.7). Among the 30 patients with HPV infection detectable by DNA testing at baseline, 9 (30%) developed SIL. The independent risk factors for the incident SIL in this group of SLE patients included the use of cyclophosphamide (CYC) ever (odds ratio [OR] 5.6, 95% confidence interval [95% CI] 1.1-29.3; P=0.041) and persistent high-risk HPV infection (OR 26.9, 95% CI 3.2-222.3; P=0.002). The use of baseline HPV testing has a higher sensitivity than abnormal cytology (defined as atypical squamous cells of undetermined significance; 47.7% versus 33.3%) in predicting the development of SIL. CONCLUSION: Independent risk factors associated with the development of SIL in SLE patients included persistent high-risk HPV infection and the use of CYC. Low-risk patients who receive negative test results on both cervical cytology screening and HPV DNA testing may not need to be rescreened within 3 years. SN - 2151-4658 UR - https://www.unboundmedicine.com/medline/citation/20890985/Risk_factors_for_squamous_intraepithelial_lesions_in_systemic_lupus_erythematosus:_a_prospective_cohort_study_ L2 - https://doi.org/10.1002/acr.20367 DB - PRIME DP - Unbound Medicine ER -