title: Human papillomavirus genotyping as a reliable prognostic marker of recurrence after loop electrosurgical excision procedure for high-grade cervical intraepithelial neoplasia (CIN2-3) especially in postmenopausal women.
abstract: OBJECTIVE
  This study was conducted to determine, using the HPV DNA Chip (HDC) test, whether the human papillomavirus (HPV) genotype is predictive of recurrent high-grade cervical intraepithelial neoplasia (CIN; CIN2-3) after a loop electrosurgical excision procedure (LEEP) in postmenopausal women.
  
  
  METHODS
  Between January 2007 and February 2013, 206 postmenopausal women with CIN2-3 were treated with LEEP, followed by cytology, Hybrid Capture II (HC2) assay, and HDC test. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24 months during the first 2 years and yearly thereafter.
  
  
  RESULTS
  Among 206 women, HC2 yielded positive results in 199 women (96.6%) and HDC yielded positive results in 201 women (97.6%) before LEEP. The overall agreement between HDC and HC2 was 99.0%. The area under the receiver operating characteristic curve for high-risk HPV (HR-HPV) viral load measured by HC2 predicting recurrent CIN2-3 was 0.567 (P = 0.335). Twenty-six women (12.6%) developed recurrence, and those who developed recurrence tested positive for the same HR-HPV genotype before and after LEEP. The same HR-HPV genotype by HDC during follow-up had a sensitivity and negative predictive value of 100% in detecting recurrent disease. HPV-18 was significantly associated with recurrent CIN2-3 (P < 0.05).
  
  
  CONCLUSIONS
  Among postmenopausal women, persistent infection with the same HR-HPV genotype, especially HPV-18, should be considered a risk factor for developing recurrent CIN2-3. After LEEP, such women warrant special attention with intense follow-up.
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: Seok Mo
authors.initials: SM
authors.lastname: Kim
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis; D002584:Cervix Uteri / Q000601:surgery / Q000821:virology; D004279:DNA, Viral / Q000032:analysis*; D004598:Electrosurgery / Q000379:methods; D005260:Female; D005838:Genotype; D061809:Human Papillomavirus DNA Tests; D052161:Human papillomavirus 18 / Q000235:genetics; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics*; D017698:Postmenopause; D011379:Prognosis; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000601:surgery / Q000821:virology*; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000601:surgery / Q000821:virology*
chemical_list: D014408:Biomarkers, Tumor; D004279:DNA, Viral