Significance of human papillomavirus genotyping with high-grade cervical intraepithelial neoplasia treated by a loop electrosurgical excision procedure

Am J Obstet Gynecol. 2010 Jul;203(1):72.e1-6. doi: 10.1016/j.ajog.2010.01.063. Epub 2010 Apr 24.

Abstract

Objective: This study was conducted to determine whether the human papillomavirus (HPV) genotype by the HPV DNA chip test (HDC) is predictive of residual or recurrent high-grade cervical intraepithelial neoplasia (CIN) 2-3 following a loop electrosurgical excision procedure (LEEP).

Study design: Between January 2001-February 2007, 672 patients with CIN2-3 were treated by a LEEP and followed up with cytology, the hybrid capture II assay, and the HDC.

Results: A total of 37 (5.5%) patients developed a recurrence, and those who developed a recurrence tested positive for the same high-risk (HR) HPV genotype before and after the LEEP. The same HR-HPV genotype by the HDC during the follow-up had a sensitivity and negative predictive value of 100% for detecting residual/recurrent disease. Persistent HPV-16 and HPV-18 were significantly associated with recurrent CIN2-3 (P < .05).

Conclusion: Persistent infection with the same HR-HPV genotype, especially HPV-16 and HPV-18, should be considered a risk factor for developing residual/recurrent CIN2-3.

MeSH terms

  • Adult
  • DNA, Viral / chemistry
  • DNA, Viral / genetics
  • Electrosurgery
  • Female
  • Genotype
  • Histocytochemistry
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / pathology*
  • Neoplasm Recurrence, Local / virology
  • Papillomaviridae / genetics*
  • Papillomavirus Infections / pathology*
  • Papillomavirus Infections / surgery
  • Papillomavirus Infections / virology
  • Polymerase Chain Reaction
  • Predictive Value of Tests
  • ROC Curve
  • Reproducibility of Results
  • Sensitivity and Specificity
  • Uterine Cervical Dysplasia / pathology
  • Uterine Cervical Dysplasia / surgery
  • Uterine Cervical Dysplasia / virology*
  • Uterine Cervical Neoplasms / pathology
  • Uterine Cervical Neoplasms / surgery
  • Uterine Cervical Neoplasms / virology*
  • Young Adult

Substances

  • DNA, Viral