Predicting treatment outcome in cervical diseases using liquid-based cytology, dynamic HPV genotyping and DNA cytometry.
BACKGROUND
In this study, our prospective experience with a multimodal follow-up protocol is summarized, with special emphasis on predicting the treatment outcome of cervical diseases.


METHODS
Liquid-based cytology samples (ThinPrep) from 209 women exhibiting the whole spectrum of human papilloma virus (HPV)-related cervical diseases were investigated by cytology, PCR-based HPV genotyping and DNA cytometry pre-surgery. The first control cytology and type-specific HPV tests were performed at 3 months post-surgery.


RESULTS
The success rate of surgery was 95% in eradicating high-grade cervical disease and 90% in eliminating the baseline HPV genotype. Treatment failure was significantly correlated with baseline cytology (p=0.011), resection margin status (p=0.016) and HPV positivity at 3 months post-surgery (p=0.04). Multivariate logistic regression analysis showed that type-specific persistent HPV infection (p=0.028), baseline cytology (p=0.039) and histology (p=0.065) were independent predictors of residual cervical neoplasias.


CONCLUSIONS
Our results showed that our multimodal surveillance protocol may help to individually assess the anticipated clinical outcome of cervical diseases post-surgery.
Bollmann
Magdolna
M
Institute of Pathology, Bonn-Duisdorf, Germany.
Várnai
Alinda Dalma
AD
Griefingholt
Harald
H
Bánkfalvi
Agnes
A
Callenberg
Helene
H
Speich
Norbert
N
Schmitt
Christoph
C
Bollmann
Reinhard
R
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003218:Condylomata Acuminata / Q000473:pathology / Q000601:surgery / Q000821:virology; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D005838:Genotype; D006801:Humans; D008875:Middle Aged; D018365:Neoplasm, Residual / Q000473:pathology / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D011003:Ploidies; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D002577:Uterine Cervical Diseases / Q000473:pathology / Q000601:surgery* / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology; D014626:Vaginal Smears; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery / Q000821:virology