Surgery for cervical intraepithelial neoplasia

Martin-Hirsch, P; Paraskevaidis, Evangelos; Bryant, Andrew; Dickinson, Heather O; Keep, Sarah L

doi:10.1002/14651858.cd001318.pub3

Cited by 182 publications

(94 citation statements)

References 59 publications

(92 reference statements)

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“…The two test methods evaluated in our study, hc2 and RealTime, were shown to have clinical sensitivity and specificity of 100 and 78.8 % (hc2)/specificity 84. 8 [17,18,22]). Similar to our findings these studies also found a tendency towards higher specificity for RealTime compared to hc2 and higher clinical sensitivity for hc2.…”

Section: Hpv Statusmentioning

confidence: 99%

See 1 more Smart Citation

The Value of Partial HPV Genotyping After Conization of Cervical Dysplasias

Friebe

Klapdor

Hillemanns

et al. 2017

Geburtshilfe Frauenheilkd

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Introduction In this retrospective study partial genotyping of human papilloma viruses (HPV) using the Abbott RealTime HighRisk HPV Test (RealTime) was compared with simple HPV detection (Qiagen Hybrid Capture 2 Test; hc2) for recurrence prediction at the first follow-up examination after conization of cervical intraepithelial neoplasia (CIN). Methods 144 women who had undergone conization for CIN between January 2007 and December 2013 were included. HPV status was determined preoperatively and at first follow-up using hc2 in 103 women and RealTime in 41 women. Recurrent or persistent CIN was assumed when CIN2+ was confirmed histologically or on comparable cytology findings. Results Of the 144 women with complete data 12 (8.3%) had a recurrence after conization. HPV persistence at follow-up correlated significantly with recurrence (hc2: p = 0.003; RealTime: p = 0.003) and both sensitivity and specificity were high (hc2 = 100 and 78.4% respectively; RealTime = 75.0 and 83.9%). Whereas isolated HPV testing had a relatively low positive predictive value for recurrence (hc2 16%; RealTime 54.5%), this rose to 80% with HPV 16 detection at follow-up. Conclusion At follow-up after conization of CIN the combination of high risk HPV detection and partial genotyping of HPV 16 constitutes excellent diagnostic criteria for recurrence/persistence of CIN.

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Section: Hpv Statusmentioning

confidence: 99%

“…Loop excision is the most commonly used method, which, in contrast to e.g. laser ablation, allows acquisition of a cone biopsy for histological analysis and assessment of endo-and ectocervical resection margins [8,9].…”

Section: Introductionmentioning

confidence: 99%

The Value of Partial HPV Genotyping After Conization of Cervical Dysplasias

Friebe

Klapdor

Hillemanns

et al. 2017

Geburtshilfe Frauenheilkd

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“…Cervical carcinogenesis is a very slow process that lasts approximately 15-30 years from initial hrHPV infection to cancer development [8]. This process is characterized by cytomorphologically recognizable premalignant stages, which can be adequately treated to prevent progression to cancer [9]. For these reasons, cervical cancer is an ideal screening target.…”

Section: Introductionmentioning

confidence: 99%

Management of high-risk HPV-positive women for detection of cervical (pre)cancer

Luttmer

Strooper

Steenbergen

et al. 2016

Expert Review of Molecular Diagnostics

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Introduction: Primary HPV-testing has been shown to provide a superior detection of women at risk of cervical (pre)cancer compared to cytology-based screening. However, as most high-risk HPV infections are harmless, additional triage testing of HPV-positive women is necessary to identify those with cervical (pre)cancer. In this paper, we compare the performance, advantages and limitations of clinically relevant available triage strategies for HPV-positive women. Areas covered: Many different colposcopy triage strategies, comprising both microscopy-based and molecular (virus/host-related) markers, have been suggested: Pap cytology, p16/Ki-67 dual-stained cytology, HPV16/18 genotyping, viral DNA methylation and host cell DNA methylation. Literature search was limited to triage strategies that have achieved at least phase 2 of the five-phase framework for biomarker development and studies including large cohorts (≥100 hrHPV-positive women). Triage markers were stratified by sample type (cervical scrape, self-collected sample) and by study population (screening, non-attendee, referral). Expert commentary: At present, repeat Pap cytology and Pap cytology combined with HPV16/18 genotyping are the only triage strategies that have been robustly shown to be ready for implementation. Other strategies such as p16/Ki-67 dual-stained cytology and host cell DNA methylation analysis, with or without additional HPV16/18 genotyping, are attractive options for the near future. ARTICLE HISTORY

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“…We must keep in mind that these patients are mostly of childbearing age and desire preservation of fertility. Repeated treatments on the cervix can cause negative sequelae in their reproductive health [3].…”

Section: Introductionmentioning

confidence: 99%

The Value of HPV-HR DNA Testing During the Follow-Up After Treatment of CIN3/AIS

Banović

Mahovlić

Salopek

et al. 2014

Pathol. Oncol. Res.

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There is still debate on what is the optimal follow-up protocol after a treatment for preinvasive cervical disease. We performed this study in order to improve diagnostic accuracy of the follow-up protocol and at the same time reducing the number of overtreated patients. One hundred and fourteen patients were followed up after conization for CIN3 and/or AIS at 3-6 month, 9-12 month and 18-24 month intervals, then yearly. The follow-up consisted of cytology, colposcopy with biopsy if needed and HPV testing. The end-point of the study was a secondary treatment due to a high suspicion of resdidual/recurrent disease or disease free period of at least 24 months. The median follow-up time was 41 months (5-72 months). In predicting residual/recurrent disease cytology had a specificity of 88.9%, sensitivity of 100%, PPV of 33.3% and a NPV of 100% whereas HPV had a specificity of 76.9%, sensitivity of 100%, PPV of 21.4% and a NPV of 100%. According to our results both tests can be used as a primary follow-up tool after conization. The choice should depend on a socio-economic aspect. In our setting the HPV test should be done only in those patients with a positive smear any time during follow-up as the point of decision for a second treatment. With this approach we could considerably decrease the number of reoperated patients and co-morbidities.

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Surgery for cervical intraepithelial neoplasia

Cited by 182 publications

References 59 publications

The Value of Partial HPV Genotyping After Conization of Cervical Dysplasias

The Value of Partial HPV Genotyping After Conization of Cervical Dysplasias

Management of high-risk HPV-positive women for detection of cervical (pre)cancer

The Value of HPV-HR DNA Testing During the Follow-Up After Treatment of CIN3/AIS

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