Early human papillomavirus testing predicts residual/recurrent disease after LEEP
- Authors
- Ryu, Aeli; Nam, Kyehyun; Kwak, Jeongja; Kim, Jeongsig; Jeon, Seob
- Issue Date
- Oct-2012
- Publisher
- 대한부인종양학회
- Keywords
- Cervical intraepithelial neoplasia; Follow-up; Human papillomavirus; Loop electrosurgical excision procedure
- Citation
- Journal of Gynecologic Oncology, v.23, no.4, pp 217 - 225
- Pages
- 9
- Journal Title
- Journal of Gynecologic Oncology
- Volume
- 23
- Number
- 4
- Start Page
- 217
- End Page
- 225
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/14800
- DOI
- 10.3802/jgo.2012.23.4.217
- ISSN
- 2005-0380
2005-0399
- Abstract
- Objective: The purpose of this study was to determine the predictive factors for residual/recurrent disease and to analyze the timing for Pap smears and human papillomavirus (HPV) testing during follow-up after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2 or worse. Methods: We retrospectively analyzed 183 patients (mean age, 39.3 years) with CIN 2/3 who were treated with LEEP. Post-LEEP follow-up was performed by Pap smear and HPV hybrid capture2 (HC2) testing. The definition of persistent/recurrent disease was biopsy-proven CIN 2 or worse. Results: Among 183 patients, punch biopsies were CIN 2 in 31 (16.9%) and CIN 3 in 152(83.1%). HPV HC2 tests before LEEP were positive in 170(95.5%) of 178 patients. During follow-up, 12 patients (6.6%) had residual/recurrent CIN 2+. LEEP margin status was a significant predictive factor for persistent/recurrent disease. Other factors such as age, HPV HC2 viral load (>= 100 relative light units), and HPV typing (type 16/18 vs. other types) did not predict recurrence. Early HPV HC2 testing at 3 months after LEEP detected all cases of residual/recurrent disease. The sensitivity and negative predictive value of the HPV HC2 test for residual/recurrent disease were both 100% at 3 and 6 months. Conclusion: Margin involvement in conization specimens was a significant factor predicting-residual/recurrent disease after LEEP. HPV test results at 3 and 6 months after treatment were comparable. Early 3-month follow-up testing after LEEP can offer timely information about residual/recurrent disease and alleviate patient anxiety early about treatment failure.
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Collections - College of Medicine > Department of Obstetrics and Gynecology > 1. Journal Articles
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- College of Medicine > Department of Pathology > 1. Journal Articles
- College of Medicine > Department of Obstetrics and Gynecology > 1. Journal Articles
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