HPV DNA Detection for Post-treatment Surveillance of Premalignant and Malignant Lesions of Cervix
- 3 Downloads
Persistence of human papilloma virus (HPV) after treatment for cervical neoplasia may be indicative of local recurrence. The aim of this study was to determine the prevalence of HPV in cervix or vagina after treatment for cervical neoplasia and to ascertain its association with local recurrence.
Data were collected retrospectively from electronic hospital medical records. The cohort consisted of women who had undergone treatment for CIN 2, CIN 3 or cervical cancer between 1 January 2014 and 31 December 2016 at a teaching hospital in India for whom post-treatment HPV results were available. Local recurrence was defined as a positive vaginal or cervical biopsy or positive radiological (PET CT) findings.
Out of a total of 101 patients, 26 had CIN 2 or 3 and 75 had cervical cancer. Post-treatment HPV was done in precancers and cancers after a mean duration of 14.9 and 8.2 months, respectively. Positive HPV detection occurred in 46.2% of precancers and 18.7% of cancers. Of the 12 precancers with positive post-treatment HPV, seven (58.3%) had recurrence, whereas among 14 cancers, three (21.4%) had recurrence. The relative risk (RR) was 4.1 (95% CI 1, 16.1) and p value 0.03 for recurrence with a positive HPV test after treatment for CIN as compared to a negative HPV result. For cancers, the RR was 3.3 (0.8, 13.9), with p = 0.09.
Positive HPV detection post-treatment is a risk factor for local recurrence in cervical neoplasia, especially in premalignant lesions. Hence, HPV testing may be useful for post-treatment surveillance.
KeywordsHPV test of cure Cervical neoplasia Post-treatment surveillance
Authors acknowledge Dr Praveen Alexander and Mr Bijesh Yadav for all scientific help.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 2.Barakat RR, Markman M, Randall M. Principles and practice of gynecologic oncology. 6th ed. Philadelphia: Lippincott Williams & Wilkins; 2009.Google Scholar
- 3.Jones J, Saleem A, Rai N, Shylasree TS, Ashman S, Gregory K, Powell N, Tristram A, Fiander A, Hibbitts S. Human Papillomavirus genotype testing combined with cytology as a “test of cure” post treatment: the importance of a persistent viral infection. J Clin Virol. 2011;52:88–92.CrossRefGoogle Scholar
- 6.Bruni L, Barrionuevo-Rosas L, Albero G, Aldea M, Serrano B, Valencia S, Brotons M, Mena M, Cosano R, Muñoz J (2015) ICO information centre on HPV and cancer (HPV Information Centre). Hum. Papillomavirus Relat. Dis. World Summ. Rep. 4Google Scholar
- 18.Zielinski GD, Bais AG, Helmerhorst TJ, Verheijen RH, de Schipper FA, Snijders PJ, Voorhorst FJ, van Kemenade FJ, Rozendaal L, Meijer CJ. HPV testing and monitoring of women after treatment of CIN 3: review of the literature and meta-analysis. Obstet Gynecol Surv. 2004;59:543–53.CrossRefGoogle Scholar
- 21.Kreimer AR, Guido RS, Solomon D, Schiffman M, Wacholder S, Jeronimo J, Wheeler CM, Castle PE. Human papillomavirus testing following loop electrosurgical excision procedure identifies women at risk for posttreatment cervical intraepithelial neoplasia grade 2 or 3 disease. Cancer Epidemiol Prev Biomark. 2006;15:908–14.CrossRefGoogle Scholar
- 24.Prato B, Ghelardi A, Gadducci A, Marchetti I, Di Cristofano C, Di Coscio G, Bevilacqua G, Genazzani AR. Correlation of recurrence rates and times with posttreatment human papillomavirus status in patients treated with loop electrosurgical excision procedure conization for cervical squamous intraepithelial lesions. Int J Gynecol Cancer. 2008;18:90–4.CrossRefGoogle Scholar
- 27.Kocken M, Uijterwaal MH, de Vries AL, Berkhof J, Ket JC, Helmerhorst TJ, Meijer CJ. High-risk human papillomavirus testing versus cytology in predicting post-treatment disease in women treated for high-grade cervical disease: a systematic review and meta-analysis. Gynecol Oncol. 2012;125:500–7.CrossRefGoogle Scholar