Eradication of HPV post-surgical treatments, its correlation with specific types, types of surgery and the physical status.
Low-risk human papillomaviruses (HPVs) will be completely eradicated as long as most visible lesions are treated. However, it is uncertain whether this is also the case for high-risk HPVs that are capable of causing cervical cancer. Many recent studies have demonstrated a high incidence of HPV persistence during post-conization or loop electrosurgical excision (LEEP) due to high-grade cervical intraepithelial neoplasia (CIN). In this report, we correlated the post-operative HPV status with pre-operative HPV type, types of surgery and HPV's physical status. Post-operative HPV E6 amplification by nested PCR was carried out for 157 female patients with positive pre-operative HPV. They underwent LEEPs, therapeutic laser conizations, and simple or radical hysterectomies. We found that high-risk types of HPVs were eradicated in 26.4% (42/159) of patients after extirpation of the lesions. The clearance rate of HPVs increased to 39.2% (40/102), excluding patients with other high-risk (OHR) kinds of type 31, 52b and 58, since OHR persisted after almost all surgeries. Eradication of HPV after radical hysterectomies are highly expected for patients with invasive cancer (70.0%, when excluding OHR), while more than half of them with CIN continue to carry pre-operative types of HPV or some different types from before treatment. Type 33 is most frequently persistent among types 16, 18 and 33. Persistent high-risk HPVs increase the risk for recurrence of post-surgical treatments of CIN, but the incidence is not high as long as the lesion is completely removed.
Fen
Jin
J
Department of Obstetrics and Gynecology, Okayama University Medical School, Okayama 700-8558, Japan.
Yoshinouchi
Mitsuo
M
Nakamura
Keiichiro
K
Kodama
Junichi
J
Nasu
Yasutomo
Y
Yamato
Kenji
K
Hiramatsu
Yuji
Y
D002278:Carcinoma in Situ / Q000473:pathology; D002584:Cervix Uteri / Q000821:virology; D005260:Female; D006801:Humans; D007044:Hysterectomy; D009361:Neoplasm Invasiveness; D027383:Papillomaviridae / Q000378:metabolism*; D012306:Risk; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000821:virology*