title: Human papillomavirus combined with cytology and margin status identifies patients at risk for recurrence after conization for high-grade cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To compare the ability of cytology, human papillomavirus (HPV) testing and co-testing to identify recurrence of patients treated by loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2-3.
  
  
  METHODS
  Retrospective analysis (R.A.): the medical records of 372 women treated for CIN 2-3 were reviewed. Resection margin, HPV typing, Pap smears, and biopsies post-LEEP were collected. Prospective analysis (P.A.): 97 women were followed post-LEEP by cytology, HPV test and colposcopy every six months.
  
  
  RESULTS
  Positive margins were found to be an independent risk factor for recurrent disease (OR 0.192; 95% CI 0.074-0.497 in R.A. and OR 0.096; 95% CI 0.023-0.392 in P.A.). HPV testing showed less sensitivity than cytology (69% vs 84%, respectively in R.A. and 80% vs 100% in P.A.). Co-testing predicted recurrent disease at a sensitivity of 90.6% in R.A. and 100% in P.A.
  
  
  CONCLUSIONS
  Co-testing is the best option in follow-up protocols after treatment for CIN 2-3. If margins are free and co-testing is negative at six and 12 months, 18 months visit could be avoided.
authors.forename: Y
authors.initials: Y
authors.lastname: Ruano
authors.forename: M
authors.initials: M
authors.lastname: Torrents
authors.forename: F J
authors.initials: FJ
authors.lastname: Ferrer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003127:Colposcopy; D019092:Conization; D004279:DNA, Viral / Q000235:genetics*; D004598:Electrosurgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000821:virology; D018365:Neoplasm, Residual; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000235:genetics; D030361:Papillomavirus Infections / Q000150:complications / Q000473:pathology*; D011379:Prognosis; D011446:Prospective Studies; D060888:Real-Time Polymerase Chain Reaction; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000150:complications / Q000473:pathology / Q000601:surgery*; D014626:Vaginal Smears; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000150:complications / Q000473:pathology / Q000601:surgery*
chemical_list: D004279:DNA, Viral