Value of cervical liquid-based cytology and high-risk human papilloma virus for patients of high-grade squamous intraepithelial lesion excised with positive margins by loop electrosurgical excision procedure

Abstract

To explore the value of cervical liquid-based cytology test (LCT) and high-risk human papilloma virus for patients of high-grade squamous intraepithelial lesion (HSIL) excised with positive margins by loop electrosurgical excision procedure (LEEP). A total of 404 HSIL patients with positive margins by LEEP and a follow-up of 12 months between June 2004 to April 2013 were recruited. The results of LCT, high-risk human papillomavirus (HR-HPV) DNA were analyzed retrospectively. According to the pathological diagnosis of re-operation, the results of LCT and HR-HPV DNA were analytically predicted for focal residue and recurrence. For patients with HSIL excised with positive margins by LEEP, the re-positive abnormality rate of LCT and/or HPV was 18.7% and the sustained positive rate of LCT and/or HPV 51.1%. The significance prediction of LCT and HR-HPV DNA examination for persistent and recurrent cervical dysplasia had a positive predictive value of 60%, a sensitivity of 100%, a positive likelihood ratio of 2.1, a negative likelihood ratio of 0.5 and an odds ratio of 4.5. For patients of HSIL excised with positive margins by loop electrosurgical excision procedure, LCT plus HR-HPV test may be effective after operation. And the positive results should be re-evaluated by colposcopy to provide rationales for re-operation.