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[Early human papillomavirus testing predicts residual/recurrent disease after LEEP risk factors for predicting residual disease in high-grade squamous cervical intraepithelial neoplasia following LEEP conization].
- Source :
-
Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition [Sichuan Da Xue Xue Bao Yi Xue Ban] 2015 Mar; Vol. 46 (2), pp. 321-5. - Publication Year :
- 2015
-
Abstract
- Objective: To explore the risk factors for residual/recurrent disease of cervical intraepithelial neoplasia (CIN) 2 or worse after loop electrosurgical excision procedure (LEEP) and the timing point for postoperative follow-up.<br />Methods: 428 patients with CIN 2 or CIN 3 who were treated with LEEP were retrospectively reviewed. Postoperative follow-up was performed by Pap smear and human papillomavirus (HPV) hybrid capture 2 (HC2) testing. The definition of persistent/recurrent disease was biopsy-proven CIN 2 or worse.<br />Results: 296 patients were CIN 2 and 132 were CIN 3 among 428 patients. The positive rate of HPV HC2 before LEEP was 86.7% (371/428). During follow-up, 26 patients (6.1%) had residual/recurrent disease, the positive LEEP margin, especially the cone top status, was a significant risk factor for persistent/recurrent disease. Other factors such as age, HPV viral load [> or =100 relative light units (RLU)], and HPV typing (type 16/18 vs. other types) did not predict recurrence. HPV HC2 test at 3 months after LEEP can find all the 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.<br />Conclusion: The positive margin of LEEP specimen especially the cone top status was a significant risk factor for residual/recurrent disease after LEEP. HPV test at 3 months during follow-up can offer timely information about residual/recurrent disease and help for the risk control in treatment selection.
- Subjects :
- Biopsy
Female
Humans
Neoplasm Recurrence, Local virology
Neoplasm, Residual virology
Papanicolaou Test
Papillomaviridae
Retrospective Studies
Risk Factors
Uterine Cervical Neoplasms surgery
Uterine Cervical Neoplasms virology
Vaginal Smears
Viral Load
Uterine Cervical Dysplasia surgery
Uterine Cervical Dysplasia virology
Conization
Neoplasm Recurrence, Local diagnosis
Neoplasm, Residual diagnosis
Uterine Cervical Neoplasms diagnosis
Uterine Cervical Dysplasia diagnosis
Subjects
Details
- Language :
- Chinese
- ISSN :
- 1672-173X
- Volume :
- 46
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Sichuan da xue xue bao. Yi xue ban = Journal of Sichuan University. Medical science edition
- Publication Type :
- Academic Journal
- Accession number :
- 25924452