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Clinical progress of human papillomavirus genotypes and their persistent infection in subjects with atypical squamous cells of undetermined significance cytology: Statistical and latent Dirichlet allocation analysis

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The present study aimed to investigate differences in prognosis based on human papillomavirus (HPV) infection, persistent infection and genotype variations for patients exhibiting atypical squamous cells of undetermined significance (ASCUS) in their initial Papanicolaou (PAP) test results. A latent Dirichlet allocation (LDA)based tool was developed that may offer a facilitated means of communication to be employed during patientdoctor consultations. The present study assessed 491 patients (139 HPVpositive and 352 HPVnegative cases) with a PAP test result of ASCUS with a followup period ≥2 years. Patients underwent PAP and HPV DNA chip tests between January 2006 and January 2009. The HPVpositive subjects were followed up with at least 2 instances of PAP and HPV DNA chip tests. The most common genotypes observed were HPV16 (25.9%, 36/139), HPV52 (14.4%, 20/139), HPV58 (13.7%, 19/139), HPV56 (11.5%, 16/139), HPV-51 (9.4%, 13/139) and HPV18 (8.6%, 12/139). A total of 33.3% (12/36) patients positive for HPV16 had cervical intraepithelial neoplasia (CIN)2 or a worse result, which was significantly higher than the prevalence of CIN2 of 1.8% (8/455) in patients negative for HPV16 (P<0.001), while no significant association was identified for other genotypes in terms of genotype and clinical progress. There was a significant association between clearance and good prognosis (P<0.001). Persistent infection was higher in patients aged ≥51 years (38.7%) than in those aged ≤50 years (20.4%; P=0.036). Progression from persistent infection to CIN2 or worse (19/34, 55.9%) was higher than clearance (0/105, 0.0%; P<0.001). In the LDA analysis, using symmetric Dirichlet priors α=0.1 and β=0.01, and clusters (k)=5 or 10 provided the most meaningful groupings. Statistical and LDA analyses produced consistent results regarding the association between persistent infection of HPV16, old age and long infection period with a clinical progression of CIN2 or worse. Therefore, LDA results may be presented as explanatory evidence during timeconstrained patientdoctor consultations in order to deliver information regarding the patient's status.
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Document Type: Research Article

Affiliations: 1: Department of Anesthesiololgy and Pain Medicine, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Kyunggido 14647, Republic of Korea 2: Biomedical Knowledge Engineering Laboratory, School of Dentistry, Seoul National University, Seoul 08826, Republic of Korea 3: Department of Biomedical Informatics, School of Medicine, University of California, San Diego, CA 92093, USA 4: Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Bucheon St. Mary's Hospital, Bucheon, Kyunggido 14647, Republic of Korea

Publication date: June 1, 2017

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  • Experimental and Therapeutic Medicine aims to ensure the expedient publication, in both print and electronic format, of studies relating to biology, gene therapy, infectious disease, microbiology, molecular cardiology and molecular surgery. The journal welcomes studies pertaining to all aspects of molecular medicine, and studies relating to in vitro or in vivo experimental model systems relevant to the mechanisms of disease are also included.

    All materials submitted to this journal undergo the appropriate review via referees who are experts in this field. All materials submitted follow international guidelines with regard to approval of experiments on humans and animals.
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