title: A human papillomavirus (HPV)-16 or HPV-18 genotype is a reliable predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure for cervical intraepithelial neoplasia 3.
abstract: OBJECTIVE
  This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3.
  
  
  METHODS
  Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens.
  
  
  RESULTS
  Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load ≥220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001).
  
  
  CONCLUSIONS
  The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: Woo Dae
authors.identifier: http://orcid.org/0000-0002-3952-9724
authors.initials: WD
authors.lastname: Kang
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea.
authors.forename: U Chul
authors.initials: UC
authors.lastname: Ju
authors.affiliation: Department of Obstetrics and Gynecology, Chonnam National University Medical School, Gwangju, Korea. seokmo2001@hanmail.net.
authors.forename: Seok Mo
authors.identifier: http://orcid.org/0000-0003-2318-0334
authors.initials: SM
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004598:Electrosurgery / Q000379:methods; D005260:Female; D005838:Genotype; D060005:Genotyping Techniques / Q000379:methods; D052162:Human papillomavirus 16 / Q000235:genetics / Q000302:isolation & purification*; D052161:Human papillomavirus 18 / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D007044:Hysterectomy; D008875:Middle Aged; D018365:Neoplasm, Residual; D030361:Papillomavirus Infections / Q000821:virology*; D011379:Prognosis; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000601:surgery* / Q000821:virology; D019562:Viral Load; D002578:Uterine Cervical Dysplasia / Q000601:surgery* / Q000821:virology
keywords: Cervical Intraepithelial Neoplasia; Conization; Human Papillomavirus; Hysterectomy; Neoplasm, Residual