American journal of obstetrics and gynecology · 2004
Usefulness of human papillomavirus testing in the follow-up of patients with high-grade cervical intraepithelial neoplasia after conization.
Оценочное исследованиеСтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод в очереди
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Chao Angel, Lin Cheng-Tao, Hsueh Swei, Chou Hung-Hsueh, Chang Ting-Chang, Chen Min-Yu, Lai Chyong-Huey
Аннотация
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.
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.
Предметные рубрики MeSH
AdenocarcinomaCarcinoma, Squamous CellCohort StudiesConizationDNA, ViralFemaleHumansLongitudinal StudiesNeoplasm Recurrence, LocalPapanicolaou TestPapillomaviridaePolymerase Chain ReactionPredictive Value of TestsProspective StudiesTaiwanUterine Cervical NeoplasmsVaginal SmearsUterine Cervical Dysplasia