Significance of HPV viral load for prediction of recurrence after treatment in patients with carcinoma in situ of cervix

Sun, Hong Gil; Yoon, Young Sun; Jeong, Nan Hee; Kim, Tak; Kim, Hai Joong; Lee, Kyu Wan; Lee, Nak Woo

Abstract

OBJECTIVE
The purpose of this study is to verify association between HPV viral load and recurrence after conization and analyse clinicopathological characteristics in patients with carcinoma in situ of cervix.
METHODS
We reviewed the chart of 154 women with carcinoma in situ who underwent conization from January 2003 to December 2005. Pap smear and high risk HPV test was performed before treatment and colposcopic examniation with biopsy was performed in necessary. After operation, repeated Pap smear and quantitative high risk HPV test (Hybrid capture II test, HC II) were performed in three month after conization for recurrence of disease. We studied the medical records of the patients, analyzed demographic characteristics and conducted the correlation between the prognostic factors of the age, parity, presence of high risk HPV infection before and after the operation, existence of invasion of resection margin after conization and remaining or recurrent lesions.
RESULTS
Positive of cone margin showed significantly high recurrence rate than negative cone margin (p<0.05). And posttreatment HPV viral load was significantly higher in recurrent patients (p<0.05). But initial Pap smear, age and parity has not shown in difference.
CONCLUSION
We can conclude that a clear association between positive cone margin, high HPV viral load and recurrence of disease after conization. A patient with positive resection margin after or high viral load after conization should be evaluated and treated aggressively.