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Arch Pathol Lab Med. 2015 Nov;139(11):1437-40. doi: 10.5858/arpa.2014-0534-OA.

The Role of High-Risk Human Papilloma Virus Testing in the Surveillance of Cervical Cancer After Treatment.

Author information

1
From the Departments of Gynecology Oncology (Drs Yu, Lin, Comerci, Edwards, Sukumvanich, Kelley, and Olawaiye), Pathology (Dr Austin), and Radiation Oncology (Dr Beriwal), Magee-Women's Hospital, Pittsburgh, Pennsylvania; and the Department of Gynecology Oncology, University of Washington, Seattle (Dr Beck).

Abstract

CONTEXT:

Cervical cancer affects 12 000 women in the United States annually. However, despite its prevalence, there remains no good methodology to detect its recurrence.

OBJECTIVE:

To identify the role of cervicovaginal high-risk human papilloma virus (hr-HPV) testing in predicting cervical cancer recurrence.

DESIGN:

This is a retrospective study of patients who underwent hr-HPV testing as part of their routine surveillance for cervical cancer. Standard statistical analyses, including χ² test and multivariable logistic regression, were performed with IBM SPSS 19.0.

RESULTS:

A total of 133 patients were identified, of whom 107 (80%) had squamous cell carcinoma. Ninety patients (68%) had bulky disease and were treated primarily with chemoradiation and brachytherapy. Of patients whose disease recurred, 5 patients (42%) had tested positive for hr-HPV during their surveillance period, compared to 13 patients (11%) for whom disease did not recur (relative risk: 3.88, P = .002). On multivariate logistic regression, hr-HPV status remained significantly predictive of disease recurrence (odds ratio: 12.3, P = .02, 95% confidence interval: 1.5-99.6). Using 2 × 2 table analysis, we found that while cervicovaginal cytology has limited specificity (5.7%) in predicting recurrence, the combination of cytology with hr-HPV testing increases the specificity of testing to 89.3%.

CONCLUSIONS:

Persistence of hr-HPV is a risk factor for disease recurrence. High-risk-HPV testing is not routinely used during surveillance for cervical cancer, but this study suggests that large, prospective trials investigating the role of hr-HPV testing in cervical cancer surveillance are needed.

PMID:
26516940
DOI:
10.5858/arpa.2014-0534-OA
[Indexed for MEDLINE]

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