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Usefulness of human papillomavirus testing in the follow-up of patients with high-grade cervical intraepithelial neoplasia after conization
- Source :
- American journal of obstetrics and gynecology. 190(4)
- Publication Year :
- 2004
-
Abstract
- 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.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.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.HPV DNA testing is useful in the follow-up and understanding of the natural history after conization for high-grade CIN.
- Subjects :
- medicine.medical_specialty
medicine.medical_treatment
Conization
Taiwan
Uterine Cervical Neoplasms
Adenocarcinoma
Cervical intraepithelial neoplasia
Polymerase Chain Reaction
Cohort Studies
Predictive Value of Tests
Carcinoma
medicine
Humans
Longitudinal Studies
Prospective Studies
Prospective cohort study
Papillomaviridae
Cervical cancer
Gynecology
Colposcopy
Vaginal Smears
Intraepithelial neoplasia
Hysterectomy
medicine.diagnostic_test
business.industry
virus diseases
Obstetrics and Gynecology
medicine.disease
Uterine Cervical Dysplasia
female genital diseases and pregnancy complications
High Grade Cervical Intraepithelial Neoplasia
DNA, Viral
Carcinoma, Squamous Cell
Female
Neoplasm Recurrence, Local
business
Papanicolaou Test
Subjects
Details
- ISSN :
- 00029378
- Volume :
- 190
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- American journal of obstetrics and gynecology
- Accession number :
- edsair.doi.dedup.....7c377cc1b0a1e52a1956e673c9ee7ce6