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Original Research

Open Access

Impact of the human papillomavirus vaccination on patients who underwent conization for high-grade cervical intraepithelial neoplasia

  • P. Ortega-Quiñonero1,*,
  • M. Remezal-Solano2
  • M.C. Carazo-Díaz3
  • D. Prieto-Merino4
  • M.I. Urbano-Reyes5
  • L. García de Guadiana-Romualdo6
  • J.P. Martínez-Cendán7

1Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena. Program of Doctorate in Health Sciences, Catholic University of Murcia (UCAM), Murcia

2Department of Obstetrics and Gynecology, Virgen de la Arrixaca University Hospital, Murcia. Catholic University of Murcia (UCAM), Murcia

3Applied Statistical Methods in Medical Research Group, Catholic University of Murcia (UCAM), Murcia

4Applied Statistical Methods in Medical Research Group, Catholic University of Murcia (UCAM), Murcia (Spain). Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London (United Kingdom)

5Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena, Murcia

6Department of Biochemestry, Santa Lucía University Hospital, Cartagena, Murcia

7Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena. Catholic University of Murcia (UCAM), Murcia (Spain)

DOI: 10.12892/ejgo4628.2019 Vol.40,Issue 3,June 2019 pp.402-407

Published: 10 June 2019

*Corresponding Author(s): P. Ortega-Quiñonero E-mail: palogine@gmail.com

Abstract

Objectives: To test whether the human papillomavirus (HPV) vaccination in patients undergoing loop diathermy conization (LEEP) for high-grade intraepithelial neoplasia (CIN 2-3) is effective in preventing recurrence of CIN 2-3 in our area. Materials and Methods: A retrospective review was conducted on 242 patients undergoing LEEP for CIN 2-3 and 42.6% received the HPV vaccine (bivalent or tetravalent) immediately before or after conization. Follow up was conducted at 3, 6, 12, 18, and 24 months to detect CIN 2-3 recurrence. Results: Regardless of the HPV type, 27 (11.1%) patients developed CIN 2-3 recurrence during post-LEEP follow up. Of the 70 vaccinated with bivalent vaccine, two (2.8%) showed recurrence, of the 33 vaccinated with tetravalent vaccine, three (9%), and of the 139 unvaccinated 61 (43.9%) developed recurrence. Of the patients infected with HPV genotypes 16/18, in the non-vaccinated group, 15 (21.7%) patients had recurrence, whereas in the vaccinated group, three (5.9%) were diagnosed with recurrence (p < 0/05). The multivariate logistic regression analysis showed that the vaccination acted as a protective factor for CIN 2-3 recurrence (OR: 0.360 (95% CI: 0.125-1.000; p < 0.05). However, neither the type of vaccine nor the time of vaccination showed a significant association with the onset of recurrence. Conclusions: The HPV vaccine appears to be a recommendable preventative strategy in reducing the risk of recurrent disease for patients treated for CIN 2-3.

Keywords

Human papillomavirus; Vaccine; Cervical intraepithelial neoplasia; Recurrent disease; Conization; LEEP

Cite and Share

P. Ortega-Quiñonero,M. Remezal-Solano,M.C. Carazo-Díaz,D. Prieto-Merino,M.I. Urbano-Reyes,L. García de Guadiana-Romualdo,J.P. Martínez-Cendán. Impact of the human papillomavirus vaccination on patients who underwent conization for high-grade cervical intraepithelial neoplasia. European Journal of Gynaecological Oncology. 2019. 40(3);402-407.

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