Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high-grade squamous intraepithelial lesion: a prospective cohort study.

Abstract

OBJECTIVE:

To evaluate if the intraoperative human papillomavirus (IOP-HPV) test has the same prognostic value as the HPV test performed at 6 months after treatment of high-grade squamous intraepithelial lesion (HSIL) to predict treatment failure.

DESIGN:

Prospective cohort study.

SETTING:

Barcelona, Spain.

POPULATION:

A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure (LEEP).

METHODS:

After LEEP, an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV2 technique. The IOP-HPV test was compared with HPV test at 6 months and with surgical margins.

MAIN OUTCOME MEASURE:

Treatment failure.

RESULTS:

Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP-HPV test, a positive 6-month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP-HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%.

CONCLUSION:

Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high-risk patients.

TWEETABLE ABSTRACT:

IOP-HPV test accurately predicts treatment failure in women with CIN 2/3.

• Authors: J Rabasa, M Bradbury, J L Sanchez-Iglesias, D Guerrero, C Forcada, A Alcalde, A Pérez-Benavente, S Cabrera, S Ramon-Cajal, J Hernandez, C Dinares, A García, C Centeno, A Gil-Moreno
• Journal: BJOG : an international journal of obstetrics and gynaecology (BJOG) Vol. 127 Issue 1 Pg. 99-105 (Jan 2020) ISSN: 1471-0528 [Electronic] England
• PMID: 31502397 (Publication Type: Evaluation Study, Journal Article)
• Copyright: © 2019 Royal College of Obstetricians and Gynaecologists.

Chemical References

• Biomarkers, Tumor

Topics

• Adult
• Alphapapillomavirus
• Biomarkers, Tumor (metabolism)
• Colposcopy (statistics & numerical data)
• Early Detection of Cancer (methods)
• Electrosurgery
• Female
• Genotype
• Human Papillomavirus DNA Tests (methods)
• Humans
• Image-Guided Biopsy
• Intraoperative Care (methods)
• Neoplasm Recurrence, Local (virology)
• Papillomavirus Infections (diagnosis)
• Prospective Studies
• Sensitivity and Specificity
• Squamous Intraepithelial Lesions (surgery, virology)
• Treatment Failure
• Uterine Cervical Neoplasms (surgery, virology)
• Uterine Cervical Dysplasia (surgery, virology)