Prediction of recurrence after treatment for high-grade cervical intraepithelial neoplasia: the role of human papillomavirus testing and age at conisation.

摘要: Objectives  The aim of this study was to examine the accuracy presence high-risk human papillomavirus (HR-HPV) DNA (HR-HPV test) postconisation as prediction recurrent or residual cervical intraepithelial neoplasia (CIN) after treatment high-grade lesions (CIN2+) in a prospective and compare with follow-up cytology marginal status excised tissue. Design  Prospective study. Setting  Unselected women presenting at colposcopy clinic University Hospital Gasthuisberg, Leuven. Population  Seventy-two treated conisation for CIN2 CIN3. Methods  Women were followed by HR-HPV test (Hybrid Capture II Digene®) every 3 6 months. same vial used (SurePath™). All further 24 months 6-month intervals. outcome >CIN2, proven colposcopy-directed biopsy occurring within treatment. correlated CIN2+. Main measures  Sensitivity, specificity, predictive values diagnostic odds ratios predict failure cure computed testing, cytology. also section margins first smear. Results  In 72 (8%), CIN occurred. recurrence significantly older than without (51.5 ± 9.6 versus 39.8 12.2 years, P= 0.007). six positive, four had positive smear (≥atypical squamous cells uncertain significance = ASCUS+) only two involved margins. Among 66 cured women, 15 an abnormal 12 Sensitivity cytology, positivity 66.7, 33.3 100% failure. Specificity three tests was, respectively, 90.9, 81.8 77.3%. showed 15% (2/13) if they normal Pap smears 50% (4/8) smears. Margin not statistically associated status. Conclusion  Persistence clearance is early valid prognostic marker CIN2+ more accurate margin time conisation. absence has negative value. Higher age may be previously unrecognised risk factor recurrence.