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Human papillomavirus type-specific persistence and recurrence after treatment for cervical dysplasia.

Söderlund Strand, Anna LU ; Kjellberg, Lennart and Dillner, Joakim LU (2013) In Journal of Medical Virology
Abstract
Human papillomavirus (HPV) infection is a necessary factor in the cervical cancer development. Also after treatment for cervical dysplasia, HPV can be present and promote the recurrence of cervical disease. In the present study, the aim was to perform a long-term follow-up on the ability of HPV testing with genotyping, as compared with cytology, to predict recurrence of high-grade cervical intraepithelial neoplasia and to evaluate the effectiveness of treatment with loop electrosurgical excision procedure (LEEP) conization. Cervical samples for HPV DNA testing and cytological analysis were obtained from 178 women with abnormal smears referred for treatment with LEEP conization. These women were scheduled for HPV DNA testing and Pap smears... (More)
Human papillomavirus (HPV) infection is a necessary factor in the cervical cancer development. Also after treatment for cervical dysplasia, HPV can be present and promote the recurrence of cervical disease. In the present study, the aim was to perform a long-term follow-up on the ability of HPV testing with genotyping, as compared with cytology, to predict recurrence of high-grade cervical intraepithelial neoplasia and to evaluate the effectiveness of treatment with loop electrosurgical excision procedure (LEEP) conization. Cervical samples for HPV DNA testing and cytological analysis were obtained from 178 women with abnormal smears referred for treatment with LEEP conization. These women were scheduled for HPV DNA testing and Pap smears before and 3, 6, 12, 24, and 36 months after treatment. Three years after treatment 3.1% (N = 4) of women were still persistently HPV-positive with the same type as had been detected at treatment. Recurrent or residual cervical intraepithelial neoplasia II+ in histopathology was found among 9 (5.1%) women during follow-up. All of these women had type-specific HPV-persistence (sensitivity 100% [95% CI 63-100%] and specificity 94.7% [89.8-97.4%]), but only 7/9 had abnormal cytology (sensitivity 77.8% [40.2-96.1%] and specificity 94.7% [89.8-97.4%]). No recurrent or residual disease was found among women with any other patterns of HPV positivity (e.g., type change or fluctuating positivity) (sensitivity 0% [95% CI 0-37.1%] and specificity 80.5% [73.5-86.0%]). In conclusion, only type-specific HPV persistence predicted recurrent or residual disease, and HPV genotyping appears useful to improve the specificity when using HPV testing in post-treatment follow-up. J. Med. Virol. © 2013 Wiley Periodicals, Inc. (Less)
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Journal of Medical Virology
publisher
John Wiley & Sons Inc.
external identifiers
  • pmid:24123176
  • wos:000330583400012
  • scopus:84893782444
  • pmid:24123176
ISSN
1096-9071
DOI
10.1002/jmv.23806
language
English
LU publication?
yes
id
e6829602-e5a5-4cf8-a428-c39a6f2d1c67 (old id 4143306)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/24123176?dopt=Abstract
date added to LUP
2016-04-01 10:30:38
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2022-04-27 22:41:53
@article{e6829602-e5a5-4cf8-a428-c39a6f2d1c67,
  abstract     = {{Human papillomavirus (HPV) infection is a necessary factor in the cervical cancer development. Also after treatment for cervical dysplasia, HPV can be present and promote the recurrence of cervical disease. In the present study, the aim was to perform a long-term follow-up on the ability of HPV testing with genotyping, as compared with cytology, to predict recurrence of high-grade cervical intraepithelial neoplasia and to evaluate the effectiveness of treatment with loop electrosurgical excision procedure (LEEP) conization. Cervical samples for HPV DNA testing and cytological analysis were obtained from 178 women with abnormal smears referred for treatment with LEEP conization. These women were scheduled for HPV DNA testing and Pap smears before and 3, 6, 12, 24, and 36 months after treatment. Three years after treatment 3.1% (N = 4) of women were still persistently HPV-positive with the same type as had been detected at treatment. Recurrent or residual cervical intraepithelial neoplasia II+ in histopathology was found among 9 (5.1%) women during follow-up. All of these women had type-specific HPV-persistence (sensitivity 100% [95% CI 63-100%] and specificity 94.7% [89.8-97.4%]), but only 7/9 had abnormal cytology (sensitivity 77.8% [40.2-96.1%] and specificity 94.7% [89.8-97.4%]). No recurrent or residual disease was found among women with any other patterns of HPV positivity (e.g., type change or fluctuating positivity) (sensitivity 0% [95% CI 0-37.1%] and specificity 80.5% [73.5-86.0%]). In conclusion, only type-specific HPV persistence predicted recurrent or residual disease, and HPV genotyping appears useful to improve the specificity when using HPV testing in post-treatment follow-up. J. Med. Virol. © 2013 Wiley Periodicals, Inc.}},
  author       = {{Söderlund Strand, Anna and Kjellberg, Lennart and Dillner, Joakim}},
  issn         = {{1096-9071}},
  language     = {{eng}},
  month        = {{10}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Journal of Medical Virology}},
  title        = {{Human papillomavirus type-specific persistence and recurrence after treatment for cervical dysplasia.}},
  url          = {{http://dx.doi.org/10.1002/jmv.23806}},
  doi          = {{10.1002/jmv.23806}},
  year         = {{2013}},
}