Role of high risk-human papilloma virus test in the follow-up of patients who underwent conization of the cervix for cervical intraepithelial neoplasia

Abstract

Objective: To examine whether the presence of high risk-human papilloma virus (HR-HPV) after conization of the cervix was a risk factor for persistence or recurrence of cervical intraepithelial neoplasia (CIN) and whether HR-HPV test could be a guideline for post-therapy surveillance. Methods:The study retrospectively analyzed data from 243 patients who underwent LLETZ or CKC of the cervix due to CIN. Results: A positive HR-HPV test result which was performed between 3 and 6 months after procedure was a risk factor for persistent or recurrent cytological (p＜0.001, odds ratio [OR]=22.51, 95% confidence interval [CI]= 9.74-52.02) and pathological (p＜0.001, OR=18.28, 95% CI=5.55-60.20) abnormalities. Conclusion: HR-HPV positive patients between 3 and 6 months after procedure should undergo frequent and meticulous post-therapy surveillance, while HR-HPV negative patients do not require such high-level surveillance and could undergo routine surveillance.

Absence of dysplasia in the excised cervix by a loop electrosurgical excision procedure in the treatment of cervical intraepithelial neoplasia

“…High HPV load before LEEP may also be associated with recurrent disease. 7 HPV persistence during follow-up after conization is significantly related to recurrence, 22 as is high preoperative viral load in the negative margin in the excised cervix. 23 A significant relationship was also found between high HPV load and recurrent disease in our study.…”

Persistent human papillomavirus DNA is associated with local recurrence after radiotherapy of uterine cervical cancer

“…5 Because positive high-risk human papillomavirus (HPV) DNA is considered as an important tool in the diagnosis of both preinvasive and invasive cervical cancer, the usefulness of the HPV test has often also been considered as a method of post-treatment surveillance. Previous studies have examined the effectiveness of the HPV DNA test as a clinically useful marker for detecting residual disease or recurrence after conservative surgical procedures for cervical intraepithelial neoplasia [6][7][8] and also after radiotherapy. [9][10][11][12] In terms of radiotherapy outcome, several past studies showed that HPV persistence is associated with high rates of local recurrence and poor overall survival in patients with cervical cancer.…”

Determination of Recurrent/Residual Cin-Ii and Cin-Iii After Leep. Cytology or HPV-Dna?

“…Our findings contrast previous studies reporting same efficacy for both tests (6, 11). Studies supporting our study also mentioned importance of HPV positivity in first 3-6 months, and good correlation of HPV negativity with both cytological and histopathologic results (12)(13)(14). It may be speculated that re-infection may impair interpretation of recurrent/residual disease status but we think our follow-up interval is quite short for possible lesions after re-infection.…”