title: Human papillomavirus type-specific persistence and reappearance after successful conization in patients with cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To assess the relationship between pre- and postoperative high-risk human papillomavirus (hrHPV) genotypes and hrHPV type-specific persistence and reappearance of abnormal cytology after successful conization.
  
  
  METHODS
  A retrospective analysis was performed of 211 patients who were undergoing conization after hrHPV genotype testing at Tottori University Hospital between July 2009 and June 2013. Of the 211 women, 129 underwent pre- and postoperative hrHPV genotype testing and were diagnosed with cervical intraepithelial neoplasia (CIN) grades 1-3 with negative margins.
  
  
  RESULTS
  The postoperative pathological diagnosis was CIN 1 in 8 patients, CIN 2 in 12, CIN 3 in 108 and adenocarcinoma in situ in 1 patient. Before conization, the most frequent hrHPV genotypes were HPV16 (n = 52; 40.3 %), followed by HPV52 (n = 32; 24.8 %) and HPV58 (n = 28; 21.7 %), while HPV18 was detected in 6 cases (4.7 %). Of the 23 postoperative hrHPV-positive cases, the same genotypes were detected in 10 cases while a different genotype was detected in 11 cases; type did not affect the frequency of persistent postoperative infection. The 3-year cumulative risk for the reappearance of abnormal cytology was significantly higher in postoperative hrHPV-positive patients than in postoperative hrHPV-negative patients (31.6 vs 9.7 %, P = 0.0014). A high-grade squamous intraepithelial lesion (HSIL) was observed during the follow-up period in one patient with persistent HPV16 infection.
  
  
  CONCLUSIONS
  Postoperative hrHPV infection was a significant positive predictor for the reappearance of abnormal cytology and HPV16 infection-induced HSIL after treatment. Therefore, our study suggests that hrHPV genotype testing may be useful to follow-up CIN patients.
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Akiko
authors.initials: A
authors.lastname: Kudoh
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Sato
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan. itamochi@hotmail.com.|Depertment of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka-City, Iwate, 020-8505, Japan. itamochi@hotmail.com.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Itamochi
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Komatsu
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Michiko
authors.initials: M
authors.lastname: Nonaka
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.|Depertment of Obstetrics and Gynecology, Iwate Medical University School of Medicine, 19-1 Uchimaru, Morioka-City, Iwate, 020-8505, Japan.
authors.forename: Seiya
authors.initials: S
authors.lastname: Sato
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Jun
authors.initials: J
authors.lastname: Chikumi
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Muneaki
authors.initials: M
authors.lastname: Shimada
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Oishi
authors.affiliation: Matsue City Hospital, 32-1 Noshira, Matsue-City, Shimane, 690-8509, Japan.
authors.forename: Junzo
authors.initials: J
authors.lastname: Kigawa
authors.affiliation: Depertment of Obstetrics and Gynecology, Tottori University School of Medicine, 36-1 Nishicho, Yonago-City, Tottori, 683-8504, Japan.
authors.forename: Tasuku
authors.initials: T
authors.lastname: Harada
mesh_terms: D065311:Adenocarcinoma in Situ / Q000601:surgery / Q000821:virology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D019092:Conization; D004279:DNA, Viral / Q000032:analysis*; D005260:Female; D005838:Genotype; D052162:Human papillomavirus 16 / Q000302:isolation & purification; D052161:Human papillomavirus 18 / Q000302:isolation & purification; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics* / Q000302:isolation & purification / Q000502:physiology; D030361:Papillomavirus Infections / Q000150:complications / Q000821:virology*; D012189:Retrospective Studies; D065310:Squamous Intraepithelial Lesions of the Cervix / Q000821:virology*; D002583:Uterine Cervical Neoplasms / Q000601:surgery / Q000821:virology*; D014626:Vaginal Smears; D014775:Virus Activation; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000601:surgery / Q000821:virology*
chemical_list: D004279:DNA, Viral
keywords: Cervical cytology; Conization; HPV genotype