The association of pre-conization high-risk HPV load and the persistence of HPV infection and persistence/recurrence of cervical intraepithelial neoplasia after conization

Abstract

Objective. The aim of this study was to evaluate whether the pre-conization high-risk human papilloma virus (HR-HPV) load is predictive for the persistence of HR-HPV infection and the persistence/recurrence of cervical intraepithelial neoplasia (CIN) after conization of the cervix. Materials and methods. A retrospective review was performed on 236 women who underwent conization due to CIN at the Center for Uterine Cancer, National Cancer Center, Korea, between March 2001 and March 2006. The samples for pre-conization HR-HPV test were obtained at least within 3 weeks before conization. All patients underwent HR-HPV testing and cytology between 3 and 6 months after conization, and subsequent follow-up of 3- to 6-month interval was performed thereafter. The persistence of HR-HPV infection and persistence/recurrence of histologic abnormality after conization were analyzed by age, parity, menopausal status, method of conization, glandular extension, margin status, severity of CIN, and pre-cone HR-HPV load in univariate and multivariate analysis. Results. In univariate analysis, high pre-cone HR-HPV load was the only risk factor for the persistence of HR-HPV infection after conization (persistent HR-HPV infection; 19.8% [23/116] of patients with an HR-HPV load ≥ 100 RLU/PC vs. 10.0% [12/120] of patients with a load < 100 RLU/PC, P = 0.034). Multivariate analysis showed that an HR-HPV load ≥ 100 RLU/PC was a risk factor for persistence/recurrence of histological abnormalities after conization ( P = 0.040, OR = 5.748, 95% CI = 1.082–30.526). Conclusion. Patients with a pre-conization HR-HPV load ≥ 100 RLU/PC had a higher rate of persistent HR-HPV infection and a higher rate of persistent/recurrent histological abnormalities after conization for CIN compared to patients with a load < 100 RLU/PC.