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

Byun, Jung Mi; Jeong, Dae Hoon; Kim, Young Nam; Jung, Eun Jung; Lee, Kyung Bok; Sung, Moon Su; Kim, Ki Tae

doi:10.1097/md.0000000000013606

Cited by 43 publications

(34 citation statements)

References 20 publications

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“…HPV infection is relatively common among females (28,29). Persistent HPV infection may cause intraepithelial pre-neoplastic lesions and invasive cervical cancer (30,31). The present study revealed that the positivity rates of HPV and HPV16 in patients with cervical cancer were 77.03 and 52.07%, respectively, which were significantly higher compared with the controls.…”

Section: Discussionmentioning

confidence: 44%

Association of estradiol and HPV/HPV16 infection with the occurrence of cervical squamous cell carcinoma

et al. 2019

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The associations between human papillomavirus (HPV) infection or hormonal exposure and cervical cancer risk are well established. However, to the best of our knowledge, the association between high endogenous estradiol levels in conjunction with HPV/HPV16 infection and the risk of cervical squamous cell carcinoma remains unknown. To investigate this, the current study conducted a matched case-control study in Shanxi Province, China, in which clinical samples were obtained from 74 females with newly diagnosed uterine cervix squamous cell carcinoma and 74 matched healthy females who were selected from 582 healthy females according to age, place of residence, marital status and menopausal status. From all participants, DNA was extracted from cells obtained from a cervical smear and serum was separated from venous blood withdrawn during days 5-8 of the menstrual cycle. HPV/HPV16 DNA and estradiol expression levels in the serum were measured by general polymerase chain reaction and enzyme-linked immunosorbent assay, respectively. Significant differences were identified in the positive HPV and HPV16 DNA expression rates between patients and controls, with odds ratios (95% confidence interval) of 3.74 (1.84-7.59) and 4.04 (1.97-8.28), respectively. Expression levels of estradiol in patients were significantly higher compared with the controls (P<0.001), however, this was only identified when the HPV16 E2 or E6 oncogene status was negative. Considering 40 ng/ml as the cutoff estradiol level, 78.38% of patients exhibited high estradiol levels, which was significantly higher than the percentage of controls (P<0.001). An additive interaction pattern was revealed between estradiol expression levels and HPV/HPV16 infection. The results suggest that among the various types of HPV, HPV16 may be most likely to cause uterine cervix squamous cell carcinoma and an abnormally high level of endogenous estradiol may further increase this risk. Therefore, estradiol therapy may represent a new treatment strategy for cases of cervical cancer associated with HPV infection.

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Section: Discussionmentioning

confidence: 44%

Association of estradiol and HPV/HPV16 infection with the occurrence of cervical squamous cell carcinoma

et al. 2019

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“…Furthermore, the possibility of re-infection after treatment should be considered. Infact, Jung Mi Byun et al [13] during follow-up, 70.7% of HPV infections were new and 29.3% were persistent, indicating a need to prevent reinfection after treatment and to regular follow-up for persistent HPV infection. HPV vaccination for HPV 16 type may be useful in preventing recurrence of CIN 2/3 and CIS.…”

Section: Discussionmentioning

confidence: 99%

HPV16 persistent infection and recurrent disease after LEEP

Bruno

Cassaro

Garofalo

et al. 2019

Virol J

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BackgroundAbout 23% of patients develop CIN2+ after LEEP treatment due to residual or recurrent lesions. The majority of patients with HPV infection were HPV negative before treatment, but 16,4% were still HPV 16 positive after treatment, indicating that conization do not necessarily clear HPV infection rapidly. The aim of this retrospective study was to evaluate the possible correlation existing between the appearance of recurring high-grade lesions and the viral genotype 16, and other risk factors such as residual disease.MethodsOne hundred eighty-two HPV positive patients underwent LEEP for CIN2+. The follow-up post treatment was carried out every 6 months. Abnormal results during follow-up were confirmed histologically and considered recurrent high-grade intraepithelial cervical lesions (CIN2/CIN3 or CIS).Statistical analysis was performed by using the SPSS software package for Windows (version 15.0, SPSS, Chicago, IL, USA). Descriptive statistics are expressed as frequency, arithmetic mean, standard deviation (S.D.) and percentages. We calculated significance (P < 0.5) with the Easy Fischer Test. We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence.ResultsIn our study, the rate of persistent infection from HPV 16, after LEEP, was 15.9% (29/182) with 94% (17/18) of the recurring disease occurring within 18 months of follow up. From this study it was found that the persistence of genotype 16 is associated with a greater rate of relapse post-conization of CIN 2+ lesions, with respect to other genotypes. Our study further supports those studies that demonstrate that the risk for residual disease or relapse is not to be overlooked, also when the margins are negative, but persistent HPV infection is present. In our case study, 40% of relapses were in women with negative margin, but with persistent HPV 16 infection. Even more so, the margins involved in HPV16 positive subjects is another prediction factor for relapse.ConclusionsOur results show the importance of genotyping and that persistent HPV 16 infection should be considered a risk factor for the development of residual/recurrent CIN 2/3.

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“…18 In a recent study, rate of persistence of high grade CIN after treatment was 25.7% and it has been shown to be mostly associated with persistent HPV 16 infection. 19 In our study, 50% of patients with different range of HPV viral load, were having persistent CIN lesions, with 31% having CIN2-3. Prognosis was strictly independent to the HPV viral load, and chance of recurrence of cervical lesions (CIN1, CIN2-3) or having better prognosis after treatment was almost the same in all patients whatever how high or low their HPV-HC2 viral load was.…”

Section: Discussionmentioning

confidence: 45%

Clinical significance of HPV-HC2 in diagnosis and prognosis of cervical lesions: a retrospective study

Hassanati

Fang

et al. 2019

Int J Reprod Contracept Obstet Gynecol

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Background: To evaluate the human papillomavirus HC2 different range detection values and their clinical significance in prediction of CIN lesions grades as well as their role in the follow-up outcome after treatment.Methods: Using the hybrid capture 2 to detect and measure the HPV and the viral load quantity, we enrolled a total of 527 HPV positive women. All patients underwent thin prep liquid-based cytology test (TCT) and only 325 underwent colposcopy guided biopsy due to abnormal cytology results. All cytology and biopsy results were collected and analyzed according to the HPV viral load. Among these patients 108 patients were followed during 2years post-operatives and their prognosis results were collected and analyzed.Results: The proportion and severity of cytological abnormalities was positively correlated with the HPV-HC2 viral load (P<0.05). There was a positive correlation between cervical biopsy results and the HPV viral load P <0.05). The more the HPV-HC2 viral load was, the higher CIN2-3 grade percentage was getting. However no statically significant correlation was found between the HPV-HC2 viral load and the follow up outcomes after treatment (P>0.05).Conclusions: High HPV-HC2 viral load is significantly associated with the severity of cervical lesions (CIN), however it does not predict any further prognosis on follow-up after treatment.

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

Cited by 43 publications

References 20 publications

Association of estradiol and HPV/HPV16 infection with the occurrence of cervical squamous cell carcinoma

Association of estradiol and HPV/HPV16 infection with the occurrence of cervical squamous cell carcinoma

HPV16 persistent infection and recurrent disease after LEEP

Clinical significance of HPV-HC2 in diagnosis and prognosis of cervical lesions: a retrospective study

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