Association between human papillomavirus infection and cytological abnormalities during early follow‐up of invasive cervical cancer

Abstract

Considering the limitations of cytology for detection of residual cervical cancer after radiotherapy, the aim of this study was to evaluate the frequency and viral load of high-risk HPV in cervical and vaginal samples during the early follow-up of patients treated for invasive cervical cancer and correlate the results with cytological examination. Conventional cytology and hybrid capture test were performed on cervical and vaginal samples of 52 women with invasive cervical carcinoma 3 months after therapy. High-risk HPV was detected in 46.1% of the samples and the median and the range of the ratio relative light unit (RLU)/cutoff (CO) (estimated viral load) in positive samples was 1.71 (1-2120.03). No significant difference was observed in viral frequency and in median of the ratio RLU/CO between samples of patients at different stages (I-III) and between cervical samples, from patients treated by exclusive radiotherapy with or without chemotherapy, and vaginal samples, from patients who underwent to hysterectomy and radiotherapy with or without chemotherapy. Cytological abnormalities were more frequent significantly in samples with HPV than in samples without HPV. The viral load was also higher significantly in samples with cytological abnormalities when compared with the samples without cytological abnormalities. In conclusion, HPV detection methods may be useful during the early follow-up as a complement to conventional cytology for the diagnosis of residual cervical cancer after radiotherapy.

HPV load and anal cytological abnormalities

“…Besides this, a high viral load (RLU/CO ≥ 100) was associated with a greater chance of progression than a low viral load (RLU/CO 1 to < 10) although a lower viral load does not inevitably exclude progressive disease . HPV load viral is also associated with the presence of residual neoplasia after treatment in cervical samples .…”

Should we search for high-risk HPV in vaginal vault Pap smear after hysterectomy due to CIN2+?

“…Recent studies suggest that HPV detection may improve the prognosis of patients treated for cervical cancer because it detects the therapeutic response of the patient, as well as the risk of developing a new cervical or vaginal cancer [28]. Other studies with patients treated with radiotherapy have made it clear that hrHPV DNA persistence is also a predictor for recurrence after therapy [24].…”

Value of human papillomavirus typing for detection of anal cytological abnormalities

“…[18] High-risk HPV may also be used post-colposcopy and post-treatment. [19] Unlike in cervical cancer, the role of HPV test as an adjunct test to cytology in screening of anal cancer has yet to be defined. Nevertheless, recent studies have shown that HPV DNA tests can be very useful to improve the sensitivity of cytology to detect AIN and in post-treatment and post-HRA follow-up, because of their excellent NPV.…”