The Value of HPV detection as a Follow-up Modality after Treatment of Cervical Precanceous Lesions

Lee, Young Seok; Kim, Chan Joo; Bae, Tae Wook; Choi, Song Kwon; Song, Min Kyung; Park, Tae Chul; Park, Jong Sup; Namkoong, Sung Eun

Abstract

OBJECTIVES
After LEEP conization of cervical precancerous lesions, cytologic follow-up and colposcopy is frequently unsatisfactory. This study was performed to investigate the relationship between the presence of human papillomavirus (HPV) and abnormal follow-up results.
METHODS
Between March 1995 and Feburary 1999, 98 patients treated by LEEP for cervical dysplasia and CIS were included. All patient had initially done HPV testing by Hybrid Capture System (Digene Co., U.S.A.). Patients were followed up with PAP, colposcopy and HPV test.
RESULTS
After mean follow-up 10.9-month follow-up, 9 patients (9.2%) had the abnormal cytology (>ASCUS). After treatment, there were 2 abnormal cytologic follow-up cases (13.3%) in the groups of koilocytosis and CIN I in initial tissue pathology, 7 abnormal follow-up cases (8.4%) in groups of CIN II/III and CIS. There was no significant difference between the recurrence rates of these two group (P=0.27). The presence of high-risk HPV DNA after LEEP was done in 26 cases. Of the HPV-positive follow-up cases, 4 patients (50%) had abnormal cytologic results. But none had abnormal cytology in HPV-negative patients.
CONCLUSION
Participants with positive follow-up HPV test have a higher recurrence rate than those with negative HPV test. Our study suggests the value of supplementary HPV DNA testing during follow-up of patients treated for cervical precancerous lesions.