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Follow up with HPV test and cytology as test of cure, 6 months after conization, is reliable

Asciutto, Katrin Christine LU ; Henic, Emir LU ; Darlin, Lotten LU ; Forslund, Ola LU and Borgfeldt, Christer LU (2016) In Acta Obstetricia et Gynecologica Scandinavica 95(11). p.1251-1257
Abstract

Introduction: Human papillomavirus (HPV) infection is an objective marker with a high sensitivity for finding cervical dysplasia. The objective of the current study is to investigate whether HPV testing, combined with liquid-based cytology, is reliable as a test of cure after the loop electrical excision procedure (LEEP). Material and methods: The LEEP was performed in 330 women for excision of cervical dysplasia. Follow up consisted of HPV testing and liquid-based cytology at six, 12, and 36 months after treatment. Patients with negative co-testing after 6 months were re-examined after 3 years. Patients who tested positive for high-risk HPV and/or dysplasia were followed up 12 months postoperatively. Results: At 6 months, the... (More)

Introduction: Human papillomavirus (HPV) infection is an objective marker with a high sensitivity for finding cervical dysplasia. The objective of the current study is to investigate whether HPV testing, combined with liquid-based cytology, is reliable as a test of cure after the loop electrical excision procedure (LEEP). Material and methods: The LEEP was performed in 330 women for excision of cervical dysplasia. Follow up consisted of HPV testing and liquid-based cytology at six, 12, and 36 months after treatment. Patients with negative co-testing after 6 months were re-examined after 3 years. Patients who tested positive for high-risk HPV and/or dysplasia were followed up 12 months postoperatively. Results: At 6 months, the co-testing was double negative in 169 of 260 tested cases (65%). A positive high-risk HPV test (n = 40) was associated with cytological abnormalities (p < 0.001). After 3 years, 227 of 275 examined cases (83%) co-tested negative, including 154 patients who had already tested negative at 6 months and 37 cases with viral clearance at 12 months. Of 26 patients with high-risk HPV at the 3-year follow up, six had LSIL findings on liquid-based cytology, but neither HSIL lesions nor glandular atypia or cervical cancer was found. A negative high-risk HPV test showed a negative predictive value for HSIL of 100% (95% CI 99.8–100%). Conclusions: Negative co-testing 6 months after LEEP can be considered a reliable test of cure as 3-year follow-up results are consistent with neither HSIL or cancer.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
cervical cancer, cervical dysplasia, cervix, conization, Human papillomavirus
in
Acta Obstetricia et Gynecologica Scandinavica
volume
95
issue
11
pages
7 pages
publisher
Wiley-Blackwell
external identifiers
  • scopus:84991688027
  • wos:000386783800007
ISSN
0001-6349
DOI
10.1111/aogs.12960
language
English
LU publication?
yes
id
3df909f3-f5a0-4289-9420-bec1d6d6de10
date added to LUP
2016-11-07 10:41:59
date last changed
2017-11-05 05:09:05
@article{3df909f3-f5a0-4289-9420-bec1d6d6de10,
  abstract     = {<p>Introduction: Human papillomavirus (HPV) infection is an objective marker with a high sensitivity for finding cervical dysplasia. The objective of the current study is to investigate whether HPV testing, combined with liquid-based cytology, is reliable as a test of cure after the loop electrical excision procedure (LEEP). Material and methods: The LEEP was performed in 330 women for excision of cervical dysplasia. Follow up consisted of HPV testing and liquid-based cytology at six, 12, and 36 months after treatment. Patients with negative co-testing after 6 months were re-examined after 3 years. Patients who tested positive for high-risk HPV and/or dysplasia were followed up 12 months postoperatively. Results: At 6 months, the co-testing was double negative in 169 of 260 tested cases (65%). A positive high-risk HPV test (n = 40) was associated with cytological abnormalities (p &lt; 0.001). After 3 years, 227 of 275 examined cases (83%) co-tested negative, including 154 patients who had already tested negative at 6 months and 37 cases with viral clearance at 12 months. Of 26 patients with high-risk HPV at the 3-year follow up, six had LSIL findings on liquid-based cytology, but neither HSIL lesions nor glandular atypia or cervical cancer was found. A negative high-risk HPV test showed a negative predictive value for HSIL of 100% (95% CI 99.8–100%). Conclusions: Negative co-testing 6 months after LEEP can be considered a reliable test of cure as 3-year follow-up results are consistent with neither HSIL or cancer.</p>},
  author       = {Asciutto, Katrin Christine and Henic, Emir and Darlin, Lotten and Forslund, Ola and Borgfeldt, Christer},
  issn         = {0001-6349},
  keyword      = {cervical cancer,cervical dysplasia,cervix,conization,Human papillomavirus},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1251--1257},
  publisher    = {Wiley-Blackwell},
  series       = {Acta Obstetricia et Gynecologica Scandinavica},
  title        = {Follow up with HPV test and cytology as test of cure, 6 months after conization, is reliable},
  url          = {http://dx.doi.org/10.1111/aogs.12960},
  volume       = {95},
  year         = {2016},
}