OBJECTIVE: We conducted a pooled analysis of published studies to compare the performance of human papillomavirus (HPV) testing and cytology in detecting residual or recurrent diseases after treatment for cervical intraepithelial neoplasia grade 2 or 3 (CIN 2/3). METHODS: Source articles presenting data on posttreatment HPV testing were identified from the National Library of Medicine (PubMed) database. We included 5,319 cases from 33 articles published between 1996 and 2013. RESULTS: The pooled sensitivity of high-risk HPV testing (0.92; 95% confidence interval [CI], 0.90 to 0.94) for detecting posttreatment CIN 2 or worse (CIN 2+) was much higher than that of cytology (0.76; 95% CI, 0.71 to 0.80). Co-testing of HPV testing and cytology maximized the sensitivity (0.93; 95% CI, 0.87 to 0.96), while HPV genotyping (detection of the same genotype between pre- and posttreatments) did not improve the sensitivity (0.89; 95% CI, 0.82 to 0.94) compared with high-risk HPV testing alone. The specificity of high-risk HPV testing (0.83; 95% CI, 0.82 to 0.84) was similar to that of cytology (0.85; 95% CI, 0.84 to 0.87) and HPV genotyping (0.83; 95% CI, 0.81 to 0.85), while co-testing had reduced specificity (0.76; 95% CI, 0.75 to 0.78). For women with positive surgical margins, high-risk HPV testing provided remarkable risk discrimination between test-positives and test-negatives (absolute risk of residual CIN 2+ 74.4% [95% CI, 64.0 to 82.6] vs. 0.8% [95% CI, 0.15 to 4.6]; p<0.001). CONCLUSION: Our findings recommend the addition of high-risk HPV testing, either alone or in conjunction with cytology, to posttreatment surveillance strategies. HPV testing can identify populations at greatest risk of posttreatment CIN 2+ lesions, especially among women with positive section margins.
Cervical Intraepithelial Neoplasia/pathology/surgery/*virology ; Female ; Humans ; Neoplasm Recurrence, Local/*virology ; Neoplasm, Residual ; Papillomaviridae/*isolation & purification ; Papillomavirus Infections/complications/*diagnosis ; Predictive Value of Tests ; Risk Assessment/methods ; Sensitivity and Specificity ; Uterine Cervical Neoplasms/pathology/surgery/*virology

OBJECTIVEThe aim of this study was to elucidate the role of EGFR expression and HPV infection and their relationship in the genesis and progression of cervical carcinoma.

METHODSThis analysis included 60 cases of cervical carcinoma, 40 cases of CIN and 30 cases of control group. Patients of cervical carcinoma group were all subjected to radical hysterectomy with bilateral pelvic lymphadenectomy in Tumour Hospital, Zhongshan University from 1997 to 2001. The FIGO stage was I a - II b. EGFR protein was stained by S-P immunohistochemistry, and HPV16/18 DNA was detected by PCR.

RESULTSThe moderate/ strong expression of EGFR was observed in 0, 42.5%, 76.7% of normal cervical epithelium, CIN and cervical tumor tissue, respectively, with a significant difference among them (P < 0.05). The infection of HPV16/18 was observed in 6.7%, 67.5%, 58.3% of normal cervical tissue, CIN and cervical tumors, respectively. The infection rate of CIN or cervical carcinoma was significantly higher than that in normal cervicaltissue (P = 0.000), but no statistically significant difference was observed between cervical carcinoma and CIN. The moderate/strong expression of EGFR demonstrated an association with the cervical invasion depth. The EGFR expression increased significantly as the invasion depth progressed from less than or equal to a half cervical stroma to deeper than that (89.2% vs. 56.5%, P = 0.004). The infection of HPV16/18 demonstrated a correlation with the cervical canal invasion. The infection increased significantly in the cases with cervical invasion than that in the cases without invasion (88.2% vs. 46.5%, P = 0.003). But no significant correlation was observed between EGFR and HPV. Neither EGFR nor HPV had a significant association with carcinoma prognosis.

CONCLUSIONEGFR and HPV demonstrate a significant correlation with genesis and progression of cervical carcinoma. In our study, neither EGFR nor HPV demonstrates a significant association with tumor prognosis, and no significant correlation is observed between EGFR and HPV.

Adenocarcinoma ; metabolism ; surgery ; virology ; Adult ; Aged ; Carcinoma, Squamous Cell ; metabolism ; surgery ; virology ; Cervical Intraepithelial Neoplasia ; metabolism ; surgery ; virology ; Female ; Follow-Up Studies ; Gene Expression Regulation, Neoplastic ; Human papillomavirus 16 ; Human papillomavirus 18 ; Humans ; Middle Aged ; Papillomavirus Infections ; Receptor, Epidermal Growth Factor ; metabolism ; Uterine Cervical Neoplasms ; metabolism ; surgery ; virology ; Young Adult

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.
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

Adult ; Antibodies, Monoclonal, Murine-Derived ; therapeutic use ; Antigens, CD20 ; metabolism ; Antineoplastic Agents ; therapeutic use ; Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Cervical Intraepithelial Neoplasia ; drug therapy ; metabolism ; pathology ; surgery ; virology ; Cyclin-Dependent Kinase Inhibitor p16 ; metabolism ; Cyclophosphamide ; therapeutic use ; Doxorubicin ; therapeutic use ; Female ; Follow-Up Studies ; Humans ; Lymphoma, Follicular ; drug therapy ; metabolism ; pathology ; surgery ; virology ; Neoplasm Staging ; Neprilysin ; metabolism ; Papillomavirus Infections ; Prednisone ; therapeutic use ; Receptors, Complement 3d ; metabolism ; Rituximab ; Uterine Cervical Neoplasms ; drug therapy ; metabolism ; pathology ; surgery ; virology ; Vincristine ; therapeutic use