Persistent HPV infection after conization in patients with negative margins

Seung Hun Song, Jae Kwan Lee, Min Jeong Oh, Jun Young Hur, Jung Yeol Na, Yong Kyun Park, Ho Suk Saw

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    43 Citations (Scopus)

    Abstract

    Objectives.: To investigate the rate of clearance of high-risk HPV after conization with negative margins and to identify the factors that may predict high-risk HPV clearance/persistence after conization with negative margins. Methods.: We performed a retrospective review of 69 patients (mean age 39.5 years, range 25-60 years) with histologically verified CIN 2 or CIN 3 who underwent electroknife conization with negative margins between March 2002 and December 2003. High-risk HPV testing was performed on cervical cytology prior to and 6 months after conization. Hybrid Capture II testing was used to detect HPV DNA. Results.: High-risk HPVs were detected in the primary cervical lesions of 67 of 69 patients (97.1%) prior to conization. Follow-up at 6 months revealed that high-risk HPVs were eradicated by conization in 82.1%. Univariate analysis showed that persistent HPV infection after conization with negative margins was more likely to occur when the pretreatment viral load was high (RLU/PC > 500) (P = 0.005). HPV infection after conization with negative margins was persistent in 43.8% (7/16) of patients with high viral load (RLU/PC > 500) and in 9.8% (5/51) of patients with low viral load (RLU/PC ≤500). Multiple regression analysis showed that high viral load (RLU/PC > 500) was the only significant independent predictor of HPV persistence (P = 0.0027). Conclusions.: High-risk HPV infections were effectively eliminated by conization with negative margins in most cases. Because high viral loads are significantly associated with high-risk HPV persistence after conization with negative margins, patients with high viral loads prior to conization should be closely followed.

    Original languageEnglish
    Pages (from-to)418-422
    Number of pages5
    JournalGynecologic Oncology
    Volume101
    Issue number3
    DOIs
    Publication statusPublished - 2006 Jun

    Keywords

    • Conization
    • Negative margins
    • Persistent HPV infection
    • Viral load

    ASJC Scopus subject areas

    • Oncology
    • Obstetrics and Gynaecology

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