Value of High-risk HPV Testing after Conization in Patients with High Grade Cervical Intraepithelial Neoplasia with Negative Margins
|Course||Obstetrics and Gynaecology|
|Keywords||high-grade cervical intraepithelial neoplasia HPV conization HPVclearance|
Objective:The aims of this study were to evaluate the outcome of high-risk HPV clearance in high-grade CIN patients after successful conization with negative margin, estimate the postoperative high-risk HPV testing to predict residual/recurrent disease.Methods:A total of245patients accepted conization (LEEP or CKC). All patients had positive high-risk HPV test (HC-2) before treatment, and negative resection margins on conization specimens after treatment. All of them accepted high-risk HPV test (HC-2) and cervical cytology at3-,6-,12,24-month follow-up visits.Result:High-risk HPV infection rates were26.5%,14.5%,8.3%,4.7%at each follow-up visits after conization, respectively. There is no significant difference in clearance rates by age, gravidity, parity, histology, cervical cytology and conization method. High HR-HPV viral load (>1000RLU/PC) before treatment was significantly associated with slow clearance, and it was the only significant independent risk factor for disease residual/recurrent (p=0.009). There were11patients had disease residual/recurrent confirmed by biopsy during2years of follow-up after treatment. High-risk HPV teating had better sensitivity and negative predictive value, but poorer specificity, compared with cervical cytology in predicting treatment failure.Conclusion:High-risk HPV infenction can be effectively removed by conization, and most of cleared within6months after treatment. High HR-HPV viral load (>1000RLU/PC) before operation slowed down the viral clearance after treatment and increased the risk of disease residual/recurrent.