title: Risk factors for human papillomavirus persistence among women undergoing cold-knife conization for treatment of high-grade cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To investigate the risk factors potentially associated with high-risk human papillomavirus (HPV) persistence in women undergoing cold-knife conization (CKC) for treatment of high-grade cervical intraepithelial neoplasia (CIN).
  
  
  METHODS
  Medical records of women who underwent CKC for treatment of CIN 2/3 between 2007 and 2012 at a tertiary hospital in Ankara, Turkey, were retrospectively analyzed. Cases involving persistent HPV infection after 1 year of follow-up were identified. Using univariate and multivariate analyses, the impact of various factors such as patient age, menopausal status, parity, high-risk HPV type, excised cone dimensions (width, height, and depth), and surgical margin status on high-risk HPV persistence was assessed.
  
  
  RESULTS
  A total of 292 women underwent CKC for treatment of CIN 2/3 within the study period. After women with a subsequent diagnosis of cervical cancer, subsequent total hysterectomy, and inadequate follow-up data were eliminated, 113 women were eligible for final analysis. High-risk HPV persistence was detected in 24 (21.2%) women, and multivariate analysis revealed that patient age and cone depth were significant independent predictors (P < 0.05).
  
  
  CONCLUSIONS
  High-risk HPV persistence may be encountered after CKC procedures. It is important to evaluate persistent HPV infections after treatment because affected women are at increased risk for disease persistence, recurrence, and progression.
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey. Electronic address: eralpbaser@gmail.com.
authors.forename: Eralp
authors.initials: E
authors.lastname: Baser
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Emre
authors.initials: E
authors.lastname: Ozgu
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Erkilinc
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Cihan
authors.initials: C
authors.lastname: Togrul
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Mete
authors.initials: M
authors.lastname: Caglar
authors.affiliation: Department of Gynecologic Oncology, Zekai Tahir Women's Health Education and Research Hospital, Ankara, Turkey.
authors.forename: Tayfun
authors.initials: T
authors.lastname: Gungor
mesh_terms: D000328:Adult; D000368:Aged; D019092:Conization / Q000379:methods*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000821:virology*; D012189:Retrospective Studies; D012307:Risk Factors; D014421:Turkey; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000601:surgery* / Q000821:virology
keywords: Cervical intraepithelial neoplasia; Cold-knife conization; Human papillomavirus