A human papillomavirus (HPV)-16 or HPV-18 genotype is a reliable predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure for cervical intraepithelial neoplasia 3.
- Author:
Woo Dae KANG
1
;
U Chul JU
;
Seok Mo KIM
Author Information
- Publication Type:Original Article
- Keywords: Cervical Intraepithelial Neoplasia; Conization; Human Papillomavirus; Hysterectomy; Neoplasm, Residual
- MeSH: Adult; Aged; Aged, 80 and over; Cervical Intraepithelial Neoplasia/*surgery/virology; Electrosurgery/methods; Female; Genotype; Genotyping Techniques/methods; Human papillomavirus 16/genetics/*isolation & purification; Human papillomavirus 18/genetics/*isolation & purification; Humans; Hysterectomy; Middle Aged; Neoplasm, Residual; Papillomavirus Infections/*virology; Prognosis; Retrospective Studies; Uterine Cervical Neoplasms/*surgery/virology; Viral Load
- From:Journal of Gynecologic Oncology 2016;27(1):e2-
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVE: This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3. METHODS: Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens. RESULTS: Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load > or =220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001). CONCLUSION: The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.
