Abstract
In this retrospective study partial genotyping of human papilloma viruses (HPV) using the Abbott RealTime HighRisk HPV Test (RealTime) was compared with simple HPV detection (Qiagen Hybrid Capture 2 Test; hc2) for recurrence prediction at the first follow-up examination after conization of cervical intraepithelial neoplasia (CIN). 144 women who had undergone conization for CIN between January 2007 and December 2013 were included. HPV status was determined preoperatively and at first follow-up using hc2 in 103 women and RealTime in 41 women. Recurrent or persistent CIN was assumed when CIN2+ was confirmed histologically or on comparable cytology findings. Of the 144 women with complete data 12 (8.3%) had a recurrence after conization. HPV persistence at follow-up correlated significantly with recurrence (hc2: p = 0.003; RealTime: p = 0.003) and both sensitivity and specificity were high (hc2 = 100 and 78.4% respectively; RealTime = 75.0 and 83.9%). Whereas isolated HPV testing had a relatively low positive predictive value for recurrence (hc2 16%; RealTime 54.5%), this rose to 80% with HPV 16 detection at follow-up. At follow-up after conization of CIN the combination of high risk HPV detection and partial genotyping of HPV16 constitutes excellent diagnostic criteria for recurrence/persistence of CIN.
Highlights
In this retrospective study partial genotyping of human papilloma viruses (HPV) using the Abbott RealTime HighRisk HPV Test (RealTime) was compared with simple HPV detection (Qiagen Hybrid Capture 2 Test; hc2) for recurrence prediction at the first follow-up examination after conization of cervical intraepithelial neoplasia (CIN)
Cone histology is shown in ▶ Table 1. Both cases of invasive carcinoma were microinvasive carcinomas that were only diagnosed at conization
In one case CIN2 was diagnosed at follow-up that was negative for p16 on immunohistochemistry and was probably not caused by high-risk type human papilloma virus (hr-HPV) but possibly by low-risk HPV
Summary
In this retrospective study partial genotyping of human papilloma viruses (HPV) using the Abbott RealTime HighRisk HPV Test (RealTime) was compared with simple HPV detection (Qiagen Hybrid Capture 2 Test; hc2) for recurrence prediction at the first follow-up examination after conization of cervical intraepithelial neoplasia (CIN). Eine HPV-Persistenz im Follow-up korrelierte signifikant mit einem Rezidiv Despite surgical intervention residual findings and recurrences occur in 5 to 25 % of cases following conization of a CIN-3 lesion. This is attributed to non-in sano resection or persistent and newly acquired HPV infections [10]
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