title: Usefulness of human papillomavirus testing in the follow-up of patients with high-grade cervical intraepithelial neoplasia after conization.
abstract: OBJECTIVE
  We aimed to define the adjunctive role of human papillomavirus (HPV) DNA testing in the follow-up of high-grade cervical intraepithelial neoplasia (CIN) after conization.
  
  
  METHODS
  We analyzed a consecutive series of 2,154 patients who received conization. Patients who had cone diagnosis of cervical cancer or CIN 1, a hysterectomy within 12 weeks after conization, and no follow-up data were excluded. The remaining 765 patients (monitored by Pap smears, colposcopy with or without high-risk HPV DNA testing) were analyzed.
  
  
  RESULTS
  Of the 765 patients, 279 had CIN at cone margin or endocervix (group A) while 486 were both margin- and endocervix-free (group B). The 3-year cumulative rate of residual/recurrent high-grade CIN was 10.3% (95% CI, 6.9-13.7). HPV follow-up status (P=.015), margin status (P=.001), and follow-up cervical cytology (P<.0001) were significant predictors for residual/recurrent high-grade CIN by multivariate analysis. Four high-grade CINs and 1 microinvasive carcinoma of group A were detected initially by HPV testing, while 48.3% (199/410) of those without recurrent/persistent high-grade CIN still had persistent HPV infection.
  
  
  CONCLUSIONS
  HPV DNA testing is useful in the follow-up and understanding of the natural history after conization for high-grade CIN.
authors.affiliation: Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and University, Linkou Medical Center, Taoyuan, Taiwan.
authors.forename: Angel
authors.initials: A
authors.lastname: Chao
authors.forename: Cheng-Tao
authors.initials: CT
authors.lastname: Lin
authors.forename: Swei
authors.initials: S
authors.lastname: Hsueh
authors.forename: Hung-Hsueh
authors.initials: HH
authors.lastname: Chou
authors.forename: Ting-Chang
authors.initials: TC
authors.lastname: Chang
authors.forename: Min-Yu
authors.initials: MY
authors.lastname: Chen
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery / Q000821:virology; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000601:surgery / Q000821:virology; D015331:Cohort Studies; D019092:Conization; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000601:surgery / Q000821:virology; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D016133:Polymerase Chain Reaction / Q000592:standards; D011237:Predictive Value of Tests; D011446:Prospective Studies; D013624:Taiwan / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000601:surgery / Q000821:virology; D014626:Vaginal Smears / Q000592:standards*; D002578:Uterine Cervical Dysplasia / Q000401:mortality* / Q000601:surgery / Q000821:virology
chemical_list: D004279:DNA, Viral