J Gynecol Oncol.  2016 Jan;27(1):e2. 10.3802/jgo.2016.27.e2.

A human papillomavirus (HPV)-16 or HPV-18 genotype is a reliable predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure for cervical intraepithelial neoplasia 3

• Kang WD
• Ju UC
• Kim SM

• KMID: 2360232
• DOI: http://doi.org/10.3802/jgo.2016.27.e2

Abstract

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.

Keyword

Cervical Intraepithelial Neoplasia; Conization; Human Papillomavirus; Hysterectomy; Neoplasm, Residual

MeSH Terms

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