The association of pre-conization high-risk HPV load and the persistence of HPV infection and persistence/recurrence of cervical intraepithelial neoplasia after conization.
OBJECTIVE
The aim of this study was to evaluate whether the pre-conization high-risk human papilloma virus (HR-HPV) load is predictive for the persistence of HR-HPV infection and the persistence/recurrence of cervical intraepithelial neoplasia (CIN) after conization of the cervix.


METHODS
A retrospective review was performed on 236 women who underwent conization due to CIN at the Center for Uterine Cancer, National Cancer Center, Korea, between March 2001 and March 2006. The samples for pre-conization HR-HPV test were obtained at least within 3 weeks before conization. All patients underwent HR-HPV testing and cytology between 3 and 6 months after conization, and subsequent follow-up of 3- to 6-month interval was performed thereafter. The persistence of HR-HPV infection and persistence/recurrence of histologic abnormality after conization were analyzed by age, parity, menopausal status, method of conization, glandular extension, margin status, severity of CIN, and pre-cone HR-HPV load in univariate and multivariate analysis.


RESULTS
In univariate analysis, high pre-cone HR-HPV load was the only risk factor for the persistence of HR-HPV infection after conization (persistent HR-HPV infection; 19.8% [23/116] of patients with an HR-HPV load > or = 100 RLU/PC vs. 10.0% [12/120] of patients with a load < 100 RLU/PC, P=0.034). Multivariate analysis showed that an HR-HPV load > or = 100 RLU/PC was a risk factor for persistence/recurrence of histological abnormalities after conization (P=0.040, OR=5.748, 95% CI=1.082-30.526).


CONCLUSIONS
Patients with a pre-conization HR-HPV load > or = 100 RLU/PC had a higher rate of persistent HR-HPV infection and a higher rate of persistent/recurrent histological abnormalities after conization for CIN compared to patients with a load < 100 RLU/PC.
Park
Jeong-Yeol
JY
Center for Uterine Cancer, Research Institute and Hospital, National Cancer Center, 809 Madu1-dong, Ilsan-gu, Goyang-si, Gyeonggi-do, 411-351, Korea.
Lee
Kyung Hee
KH
Dong
Seung Myung
SM
Kang
Sokbom
S
Park
Sang-Yoon
SY
Seo
Sang-Soo
SS
D000328:Adult; D000368:Aged; D019092:Conization / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007723:Korea / Q000453:epidemiology; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery / Q000821:virology*; D027383:Papillomaviridae / Q000472:pathogenicity*; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000601:surgery / Q000821:virology*; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000601:surgery / Q000821:virology*