title: Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2-3)?
abstract: OBJECTIVE
  This study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2-3) is effective in preventing recurrence of CIN2-3.
  
  
  METHODS
  Between August 2007 and July 2010, 737 patients aged 20-45 years who were diagnosed with CIN2-3 were treated by LEEP and followed. Three hundred and sixty patients were vaccinated with the quadrivalent HPV vaccine after LEEP (vaccination group), and 377 patients were followed without vaccination (non-vaccination group). The vaccination group received the first dose at 1 week after LEEP and the remaining two doses two and six months later. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24 months during the first 2 years and yearly thereafter.
  
  
  RESULTS
  Irrespective of causal HPV type, 36 (4.9%) patients developed recurrence. In the vaccination group (360 patients), 9 patients (2.5%) developed recurrence, whereas 27 patients (7.2%) in the non-vaccination group (377 patients) developed recurrence. In patients infected with HPV of 16 and/or 18 type, 5 patients (2.5%) in the vaccination group (197 patients) and 18 patients (8.5%) in the non-vaccination group (211 patients) developed recurrent disease related to vaccine HPV types (HPV 16 or 18 types) after LEEP (P<0.01). Multivariate analysis showed that no vaccination after LEEP was an independent risk factor for recurrent CIN2-3 (HR=2.840; 95% confidence interval, 1.335-6.042; P<0.01).
  
  
  CONCLUSIONS
  Vaccination with the quadrivalent HPV vaccine after treatment may be considered in preventing recurrence of CIN2-3.
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Republic of Korea.
authors.forename: Woo Dae
authors.initials: WD
authors.lastname: Kang
authors.forename: Ho Sun
authors.initials: HS
authors.lastname: Choi
authors.forename: Seok Mo
authors.initials: SM
authors.lastname: Kim
mesh_terms: D000328:Adult; D004598:Electrosurgery / Q000379:methods*; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000517:prevention & control*; D053918:Papillomavirus Vaccines / Q000276:immunology*; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery; D014611:Vaccination; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000517:prevention & control* / Q000601:surgery
chemical_list: D053918:Papillomavirus Vaccines
keywords: HPV; High grade CIN; LEEP; Vaccine