Effect of human papillomavirus genotype on severity and prognosis of cervical intraepithelial neoplasia

Abstract

ObjectiveThis study evaluated the effect of the specific human papillomavirus (HPV) genotypes on severity and prognosis in cervical intraepithelial neoplasia (CIN) patients.MethodsThe medical records of 446 patients treated with loop electrosurgical excision procedure (LEEP) were reviewed. The severity of CIN was categorized as CIN1/CIN2 versus CIN3+ including CIN3 and carcinoma in situ (CIS). HPV genotypes were categorized as 1) low risk, 2) intermediate risk, 3) high risk/HPV 16, 4) high risk/HPV 18, and 5) unclassified. Progression was defined as abnormal cytology, including atypical squamous cells, low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion. The margin status and progression free survival (PFS) by HPV genotypes were analyzed in 355 women with three months or more of post-treatment records.ResultsCIN3+ was the most common CIN type (67.7%), and high risk/HPV 16 (26.9%) was the most common genotype. Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2. Patients with high risk/HPV 18 showed the highest rate of positive margins (P < 0.01). The margin status proved to be the only statistically significant factor affecting PFS.ConclusionThe proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group. CIN patients with high risk/HPV 18 need to be more carefully tracked than patients with the other HPV genotypes.

Persistent HPV-16 infection leads to recurrence of high-grade cervical intraepithelial neoplasia

“…Many risk factors for recurrent dysplasia after conization have been known, but in our study, age, parity, preoperative HPV infection status, major abnormal cytology, treatment modality, margin and gland involvement, and severity of disease were not significant risk factors. Although Ku et al [14] reported that the high-risk HPV 18 genotype is related to resection margin involvement, this was not the case in our study. However, our patients who developed recurrent disease were HPV 16-positive after treatment and had persistent infection.…”

Distribution of Human Papillomavirus Genotypes among Women in Mashhad, Iran

“…The benefit of screening for this group of infections is clearly apparent [20] . Ku et al [21] investigated the impact of genotypes on the severity and prognosis of cervical neoplasia, which showed the influence of the virus type on the severity of disease. HPV18 was the most common HPV in their study, but was the second most frequent type in the present study, indicating the divergence of HPV prevalence in differing areas [22] .…”

High‐risk human papillomavirus infection in the prediction of poor treatment response and disease recurrence in patients with vulvovaginal condyloma

“…These results agree with the present data, which revealed an approximate rate of 50% HR‐HPV positivity. Using HPV typing, Sturegård et al [8] found that the most common (16.7%) high‐risk type was HPV‐16, which is responsible for most intraepithelial neoplasias and carcinomas of the lower genital tract [10,11]. Based on these findings, the authors suggested that vaccination against HPV‐16 and HPV‐18 alone could decrease the incidence of condyloma.…”