HPV16 and increased risk of recurrence after treatment for CIN.
OBJECTIVE
Addition of high-risk human papillomavirus (hrHPV) testing to post-treatment monitoring policies of women treated for high-grade cervical intraepithelial neoplasia (CIN) may improve the effectiveness of detecting recurrent/residual disease. Recent studies have shown that HPV type 16 confers an increased risk of high-grade CIN and cervical cancer. This study aimed to find out whether the post-treatment CIN3 rate is increased in HPV16-positive women treated for CIN3.


METHODS
We included 229 hrHPV-positive women treated for CIN3. HPV typing was performed by GP5+/6+-PCR followed by reverse line blotting on a cervical scrape taken before treatment. HPV typing data were related to the occurrence of post-treatment CIN3 within a median follow-up time of 20.1 months (range 3-85.4 months) following treatment.


RESULTS
Twenty nine of the 151 (19%) HPV16-positive women versus 6 of the 78 (8%) women with other hrHPV types had recurrent/residual CIN3. Post-treatment CIN3 rate was significantly increased in women with HPV16 compared to those harboring other hrHPV types (p=0.03). None of the other hrHPV types were associated with higher post-treatment CIN3 rates.


CONCLUSIONS
Women treated for HPV16 containing CIN3 should be monitored more intensively because of their increased risk of post-treatment CIN3. Thus, the HPV genotype should be considered in post-treatment monitoring policies.
Gök
Murat
M
Department of Pathology, VU University Medical Center, Amsterdam, and Department of Obstetrics and Gynaecology, Albert Schweitzer Hospital, Dordrecht, The Netherlands.
Coupé
Veerle M H
VM
Berkhof
Johannes
J
Verheijen
René H M
RH
Helmerhorst
Theo J M
TJ
Hogewoning
Cornelis J A
CJ
Snijders
Peter J F
PJ
Meijer
Chris J L M
CJ
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D052162:Human papillomavirus 16; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications*; D002583:Uterine Cervical Neoplasms / Q000628:therapy* / Q000821:virology*; D002578:Uterine Cervical Dysplasia / Q000628:therapy* / Q000821:virology*