Human papilloma virus typing at large loop excision of the transformation zone of the cervix uteri.
BACKGROUND
The aim of this study was to evaluate whether human papilloma virus (HPV) testing at LLETZ for CIN can be useful to identify patients with high risk of recurrent disease.


METHODS
In 62 women treated with LLETZ for CIN the status of the resection margins was recorded and related to the HPV status as assessed with Hybrid Capture II immediately after surgery. A control typing was repeated 3-9 months later. In all cases, a ThinPrep thinlayer cytology was further performed.


RESULTS
In 19 of the 62 surgical specimens (30.6%) the resection margin was positive for dysplasia or dysplastic epithelium was close (< 0.5 mm) to the margin (RM+), while in 43 cases (69.4%) the margins were negative (RM-). At surgery, 21 out of 62 cases (33.9%) were HPV+ (47.4% RM+, 27.9% RM-) and 13 turned HPV- at the control typing. From the 41 out of 62 (66.1%) initially HPV-cases, 12 turned into HPV+. Cytological follow-up was abnormal (ASC+) in 65% HPV+ cases, whereas all HPV- were WNL.


CONCLUSIONS
Post-operative HPV testing with HC-II is well-suited to detecting women with residual HPV infection, even in cases with negative surgical margins. Furthermore, HPV testing at surgery could replace endocervical curettage and help in distinguishing true residual disease from reinfections.
Negri
Giovanni
G
Department of Pathology, General Hospital of Bolzano, via L. Boehler 5, 39100 Bolzano, Italy. gneg@iol.it
Gampenrieder
Josef
J
Vigl
Eduard Egarter
EE
Haitel
Andrea
A
Menia
Erica
E
Mian
Christine
C
D000328:Adult; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology; D027383:Papillomaviridae / Q000145:classification* / Q000235:genetics; D030361:Papillomavirus Infections / Q000821:virology*; D012307:Risk Factors; D014412:Tumor Virus Infections / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000601:surgery* / Q000821:virology*