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Original Research

Open Access

Predictive value of HPV genotyping for recurrence of CIN2−3 in women treated by LEEP with negative resection margins

  • In Yeong Jo1
  • Woo Dae Kang1,*,
  • U Chul Ju1
  • Seok Mo Kim1

1Department of Obstetrics and Gynecology, Chonnam National University Medical School, 61469 Gwangju, Republic of Korea

DOI: 10.22514/ejgo.2023.047 Vol.44,Issue 5,October 2023 pp.97-103

Submitted: 03 April 2023 Accepted: 28 April 2023

Published: 15 October 2023

*Corresponding Author(s): Woo Dae Kang E-mail: kangwd@jnu.ac.kr

Abstract

The aim of our study was to determine whether the HPV genotype identified by the HPV DNA chip (HDC) test could predict the recurrence of high-grade cervical intraepithelial neoplasia (CIN2–3) in women who had undergone a loop electrosurgical excision procedure (LEEP) and had negative margins. We analyzed the data of 1021 women with CIN2–3 treated by LEEP where histology confirmed negative resection margins. The women were followed up with HDC and endocervical cytology tests at 3, 6, 9, 12, 18 and 24 months during the first 2 years and annually thereafter. Among the 1021 patients, the pre-LEEP HDC test was positive for 992 (97.2%). A total of 90 (8.8%) patients experienced recurrence of CIN2–3 and the post-LEEP follow-up HDC tests were positive, thus demonstrating a persistent high-risk HPV infection of the same genotype, which showed a sensitivity and negative predictive value of 100%in predicting recurrence. We also examined the correlation between pre-LEEP high-risk HPV genotypes and recurrence. The most common subtypes were HPV16, HPV18 and HPV31. Persistence of HPV18 had the highest risk of recurrence of CIN2–3 (p < 0.05). Our study suggests that type-specific persistent high-risk HPV infection, particularly the HPV18 subtype, is a significant predictor of recurrence in patients with negative resection margins in the LEEP specimens. Thus, these patients require careful monitoring, and gynecologic oncologists should conduct short-term follow-up tests.


Keywords

Loop electrosurgical excision procedure; High-grade cervical intraepithelial neoplasia; Cone margin; High-risk-human papillomavirus testing


Cite and Share

In Yeong Jo,Woo Dae Kang,U Chul Ju,Seok Mo Kim. Predictive value of HPV genotyping for recurrence of CIN2−3 in women treated by LEEP with negative resection margins. European Journal of Gynaecological Oncology. 2023. 44(5);97-103.

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