High-risk human papillomavirus testing for monitoring patients treated for high-grade cervical intraepithelial neoplasia

Nan Hee Jeong, Nak Woo Lee, Hai Joong Kim, Tak Kim, Kyu Wan Lee

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Aim: The aim of the present study was to examine the accuracy of high-risk human papillomavirus (HR-HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high-grade CIN. Methods: Ninety-five women treated by conization and loop electrosurgical excision procedure (LEEP) for high-grade CIN were followed-up with HR-HPV DNA testing (Hybrid Capture II test, Digene Diagnostics, Gaithersburg, MD, USA) and cytology at 3, 6, 12, 18 and 24 months after treatment. The outcome of our study was to detect the presence of CIN using colposcopy-directed biopsy within 24 months after treatment. Results: Women with recurrent or residual disease did not differ from women who were cured within clinicopathologic parameters at treatment. Pre-treatment HR-HPV testing was positive in all cases. In the recurrent pre-treatment group HR-HPV loads were significantly higher than in the group with no recurrence (1065.5 ± 852.3 vs 527.7 ± 669.6, P = 0.003). Residual or recurrent disease was identified in 17 patients (17.9%) during a 24-month period. A Pap smear significantly predicted disease recurrence at the first follow-up visit only. At the 6-month visit, HR-HPV testing showed 100% sensitivity and negative predictive value (NPV). When both a Pap smear and a HR-HPV test were used together, 82% sensitivity, 76% specificity and 95% NPV was noted. Performance of resection margins (odds ratio (OR) 9.8; 95% confidence interval (CI), 3.0-32.7) and post-treatment HR-HPV load >100 RLU (OR 9.3; 95% CI, 2.2-38.2) were also significant. Conclusion: HR-HPV testing in conjunction with Pap smear offers clear advantages over single cytology when monitoring women treated for high-grade CIN.

Original languageEnglish
Pages (from-to)706-711
Number of pages6
JournalJournal of Obstetrics and Gynaecology Research
Volume35
Issue number4
DOIs
Publication statusPublished - 2009 Aug 1

Fingerprint

Cervical Intraepithelial Neoplasia
Physiologic Monitoring
Papanicolaou Test
Therapeutics
Cell Biology
Odds Ratio
Confidence Intervals
Conization
Recurrence
Colposcopy
DNA
Routine Diagnostic Tests
Outcome Assessment (Health Care)
Biopsy
Sensitivity and Specificity

Keywords

  • Cervical intraepithelial neoplasia
  • High-risk HPV test
  • Human papillomavirus
  • Recurrence

ASJC Scopus subject areas

  • Obstetrics and Gynaecology

Cite this

@article{aee157d185834d4496154b358d37d6b4,
title = "High-risk human papillomavirus testing for monitoring patients treated for high-grade cervical intraepithelial neoplasia",
abstract = "Aim: The aim of the present study was to examine the accuracy of high-risk human papillomavirus (HR-HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high-grade CIN. Methods: Ninety-five women treated by conization and loop electrosurgical excision procedure (LEEP) for high-grade CIN were followed-up with HR-HPV DNA testing (Hybrid Capture II test, Digene Diagnostics, Gaithersburg, MD, USA) and cytology at 3, 6, 12, 18 and 24 months after treatment. The outcome of our study was to detect the presence of CIN using colposcopy-directed biopsy within 24 months after treatment. Results: Women with recurrent or residual disease did not differ from women who were cured within clinicopathologic parameters at treatment. Pre-treatment HR-HPV testing was positive in all cases. In the recurrent pre-treatment group HR-HPV loads were significantly higher than in the group with no recurrence (1065.5 ± 852.3 vs 527.7 ± 669.6, P = 0.003). Residual or recurrent disease was identified in 17 patients (17.9{\%}) during a 24-month period. A Pap smear significantly predicted disease recurrence at the first follow-up visit only. At the 6-month visit, HR-HPV testing showed 100{\%} sensitivity and negative predictive value (NPV). When both a Pap smear and a HR-HPV test were used together, 82{\%} sensitivity, 76{\%} specificity and 95{\%} NPV was noted. Performance of resection margins (odds ratio (OR) 9.8; 95{\%} confidence interval (CI), 3.0-32.7) and post-treatment HR-HPV load >100 RLU (OR 9.3; 95{\%} CI, 2.2-38.2) were also significant. Conclusion: HR-HPV testing in conjunction with Pap smear offers clear advantages over single cytology when monitoring women treated for high-grade CIN.",
keywords = "Cervical intraepithelial neoplasia, High-risk HPV test, Human papillomavirus, Recurrence",
author = "Jeong, {Nan Hee} and Lee, {Nak Woo} and Kim, {Hai Joong} and Tak Kim and Lee, {Kyu Wan}",
year = "2009",
month = "8",
day = "1",
doi = "10.1111/j.1447-0756.2008.00989.x",
language = "English",
volume = "35",
pages = "706--711",
journal = "Journal of Obstetrics and Gynaecology Research",
issn = "1341-8076",
publisher = "Blackwell Publishing Asia",
number = "4",

}

TY - JOUR

T1 - High-risk human papillomavirus testing for monitoring patients treated for high-grade cervical intraepithelial neoplasia

AU - Jeong, Nan Hee

AU - Lee, Nak Woo

AU - Kim, Hai Joong

AU - Kim, Tak

AU - Lee, Kyu Wan

PY - 2009/8/1

Y1 - 2009/8/1

N2 - Aim: The aim of the present study was to examine the accuracy of high-risk human papillomavirus (HR-HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high-grade CIN. Methods: Ninety-five women treated by conization and loop electrosurgical excision procedure (LEEP) for high-grade CIN were followed-up with HR-HPV DNA testing (Hybrid Capture II test, Digene Diagnostics, Gaithersburg, MD, USA) and cytology at 3, 6, 12, 18 and 24 months after treatment. The outcome of our study was to detect the presence of CIN using colposcopy-directed biopsy within 24 months after treatment. Results: Women with recurrent or residual disease did not differ from women who were cured within clinicopathologic parameters at treatment. Pre-treatment HR-HPV testing was positive in all cases. In the recurrent pre-treatment group HR-HPV loads were significantly higher than in the group with no recurrence (1065.5 ± 852.3 vs 527.7 ± 669.6, P = 0.003). Residual or recurrent disease was identified in 17 patients (17.9%) during a 24-month period. A Pap smear significantly predicted disease recurrence at the first follow-up visit only. At the 6-month visit, HR-HPV testing showed 100% sensitivity and negative predictive value (NPV). When both a Pap smear and a HR-HPV test were used together, 82% sensitivity, 76% specificity and 95% NPV was noted. Performance of resection margins (odds ratio (OR) 9.8; 95% confidence interval (CI), 3.0-32.7) and post-treatment HR-HPV load >100 RLU (OR 9.3; 95% CI, 2.2-38.2) were also significant. Conclusion: HR-HPV testing in conjunction with Pap smear offers clear advantages over single cytology when monitoring women treated for high-grade CIN.

AB - Aim: The aim of the present study was to examine the accuracy of high-risk human papillomavirus (HR-HPV) DNA detection as a predictor of residual or recurrent cervical intraepithelial neoplasia (CIN) after treatment of high-grade CIN. Methods: Ninety-five women treated by conization and loop electrosurgical excision procedure (LEEP) for high-grade CIN were followed-up with HR-HPV DNA testing (Hybrid Capture II test, Digene Diagnostics, Gaithersburg, MD, USA) and cytology at 3, 6, 12, 18 and 24 months after treatment. The outcome of our study was to detect the presence of CIN using colposcopy-directed biopsy within 24 months after treatment. Results: Women with recurrent or residual disease did not differ from women who were cured within clinicopathologic parameters at treatment. Pre-treatment HR-HPV testing was positive in all cases. In the recurrent pre-treatment group HR-HPV loads were significantly higher than in the group with no recurrence (1065.5 ± 852.3 vs 527.7 ± 669.6, P = 0.003). Residual or recurrent disease was identified in 17 patients (17.9%) during a 24-month period. A Pap smear significantly predicted disease recurrence at the first follow-up visit only. At the 6-month visit, HR-HPV testing showed 100% sensitivity and negative predictive value (NPV). When both a Pap smear and a HR-HPV test were used together, 82% sensitivity, 76% specificity and 95% NPV was noted. Performance of resection margins (odds ratio (OR) 9.8; 95% confidence interval (CI), 3.0-32.7) and post-treatment HR-HPV load >100 RLU (OR 9.3; 95% CI, 2.2-38.2) were also significant. Conclusion: HR-HPV testing in conjunction with Pap smear offers clear advantages over single cytology when monitoring women treated for high-grade CIN.

KW - Cervical intraepithelial neoplasia

KW - High-risk HPV test

KW - Human papillomavirus

KW - Recurrence

UR - http://www.scopus.com/inward/record.url?scp=70049113995&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70049113995&partnerID=8YFLogxK

U2 - 10.1111/j.1447-0756.2008.00989.x

DO - 10.1111/j.1447-0756.2008.00989.x

M3 - Article

C2 - 19751331

AN - SCOPUS:70049113995

VL - 35

SP - 706

EP - 711

JO - Journal of Obstetrics and Gynaecology Research

JF - Journal of Obstetrics and Gynaecology Research

SN - 1341-8076

IS - 4

ER -