Usefulness of human papillomavirus testing in the follow-up of patients with high-grade cervical intraepithelial neoplasia after conization

Angel Chao, Cheng Tao Lin, Swei Hsueh, Hung Hsueh Chou, Ting Chang Chang, Min Yu Chen, Chyong Huey Lai*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review

56 Scopus citations

Abstract

Objective: We aimed to define the adjunctive role of human papillomavirus (HPV) DNA testing in the follow-up of high-grade cervical intraepithelial neoplasia (CIN) after conization. Study design: We analyzed a consecutive series of 2,154 patients who received conization. Patients who had cone diagnosis of cervical cancer or CIN 1, a hysterectomy within 12 weeks after conization, and no follow-up data were excluded. The remaining 765 patients (monitored by Pap smears, colposcopy with or without high-risk HPV DNA testing) were analyzed. Results: Of the 765 patients, 279 had CIN at cone margin or endocervix (group A) while 486 were both margin- and endocervix-free (group B). The 3-year cumulative rate of residual/recurrent high-grade CIN was 10.3% (95% CI, 6.9-13.7). HPV follow-up status (P = .015), margin status (P = .001), and follow-up cervical cytology (P < .0001) were significant predictors for residual/ recurrent high-grade CIN by multivariate analysis. Four high-grade CINs and 1 microinvasive carcinoma of group A were detected initially by HPV testing, while 48.3% (199/410) of those without recurrent/persistent high-grade CIN still had persistent HPV infection. Conclusion: HPV DNA testing is useful in the follow-up and understanding of the natural history after conization for high-grade CIN.

Original languageEnglish
Pages (from-to)1046-1051
Number of pages6
JournalAmerican Journal of Obstetrics and Gynecology
Volume190
Issue number4
DOIs
StatePublished - 04 2004
Externally publishedYes

Keywords

  • Cervical neoplasms
  • Conization
  • Follow-up
  • Human papillomavirus

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