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Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia

ANNELIES AERSSENS UGent, Patricia Claeys, ELISABETH BEERENS UGent, A Garcia, Steven Weyers UGent, Lieve Van Renterghem, Marleen Praet UGent, Marleen Temmerman UGent, R Velasquez and Claude Cuvelier UGent (2009) CYTOPATHOLOGY. 20(1). p.27-35
abstract
Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia To assess the role of human papillomavirus (HPV) testing and cytology as predictors of residual/recurrent disease after treatment of high-grade cervical intraepithelial lesions. One hundred and thirty-eight women with cervical intraepithelial neoplasia (CIN) grade 2/3 lesion on biopsy were included in a prospective follow-up study in Belgium and Nicaragua. All women were treated with loop electrosurgical excision procedure (LEEP) and follow-up visits took place at 6 weeks, 6 months, 1 year and 2 years. During these visits, a Papanicolaou (Pap) smear test was taken, colposcopy was performed and specimens were collected for HPV testing. Cytology, high-risk (HR) HPV presence, persistent HR HPV infection and combinations of these tests at different time points during follow-up were correlated with histologically confirmed residual/recurrent disease. Thirteen patients (9%) developed residual/recurrent disease during follow-up. Abnormal cytology at 6 weeks after treatment was significantly correlated with residual/recurrent disease. Nine of thirty-seven patients with abnormal cytology at 6 weeks had recurrent disease versus three of seventy with a normal cytology [odds ratio (OR): 7.2; 95% confidence interval (CI): 1.8-28.5; P = 0.003). Sensitivity of this test was 75.0%, specificity 70.5%. Combining abnormal cytology and the presence of HR HPV within the first 6 months after treatment gave the best correlation with residual/recurrent disease: of the 54 women with abnormal cytology and/or HR HPV presence within the first 6 months, 11 developed residual/recurrent disease (OR 10.2; 95% CI: 2.2-48.3). Sensitivity of this combination was 84.6% and specificity 65.0%. Cytology remains the cornerstone in the early follow-up after LEEP for CIN lesions of the cervix. HPV testing can add value as it increases the sensitivity of cytology in concomitant testing within the first 6 months.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
journal title
CYTOPATHOLOGY
volume
20
issue
1
pages
27 - 35
Web of Science type
Article
Web of Science id
000262314800005
JCR category
PATHOLOGY
JCR impact factor
1.349 (2009)
JCR rank
48/71 (2009)
JCR quartile
3 (2009)
ISSN
0956-5507
DOI
10.1111/j.1365-2303.2008.00567.x
language
English
UGent publication?
yes
classification
A1
id
519768
handle
http://hdl.handle.net/1854/LU-519768
date created
2009-03-17 09:49:54
date last changed
2010-03-26 13:38:40
@article{519768,
  abstract     = {Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia
To assess the role of human papillomavirus (HPV) testing and cytology as predictors of residual/recurrent disease after treatment of high-grade cervical intraepithelial lesions.

One hundred and thirty-eight women with cervical intraepithelial neoplasia (CIN) grade 2/3 lesion on biopsy were included in a prospective follow-up study in Belgium and Nicaragua. All women were treated with loop electrosurgical excision procedure (LEEP) and follow-up visits took place at 6 weeks, 6 months, 1 year and 2 years. During these visits, a Papanicolaou (Pap) smear test was taken, colposcopy was performed and specimens were collected for HPV testing. Cytology, high-risk (HR) HPV presence, persistent HR HPV infection and combinations of these tests at different time points during follow-up were correlated with histologically confirmed residual/recurrent disease.

Thirteen patients (9\%) developed residual/recurrent disease during follow-up. Abnormal cytology at 6 weeks after treatment was significantly correlated with residual/recurrent disease. Nine of thirty-seven patients with abnormal cytology at 6 weeks had recurrent disease versus three of seventy with a normal cytology [odds ratio (OR): 7.2; 95\% confidence interval (CI): 1.8-28.5; P = 0.003). Sensitivity of this test was 75.0\%, specificity 70.5\%. Combining abnormal cytology and the presence of HR HPV within the first 6 months after treatment gave the best correlation with residual/recurrent disease: of the 54 women with abnormal cytology and/or HR HPV presence within the first 6 months, 11 developed residual/recurrent disease (OR 10.2; 95\% CI: 2.2-48.3). Sensitivity of this combination was 84.6\% and specificity 65.0\%.

Cytology remains the cornerstone in the early follow-up after LEEP for CIN lesions of the cervix. HPV testing can add value as it increases the sensitivity of cytology in concomitant testing within the first 6 months.},
  author       = {AERSSENS, ANNELIES and Claeys, Patricia and BEERENS, ELISABETH and Garcia, A and Weyers, Steven and Van Renterghem, Lieve and Praet, Marleen and Temmerman, Marleen and Velasquez, R and Cuvelier, Claude},
  issn         = {0956-5507},
  journal      = {CYTOPATHOLOGY},
  language     = {eng},
  number       = {1},
  pages        = {27--35},
  title        = {Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia},
  url          = {http://dx.doi.org/10.1111/j.1365-2303.2008.00567.x},
  volume       = {20},
  year         = {2009},
}

Chicago
AERSSENS, ANNELIES, Patricia Claeys, ELISABETH BEERENS, A Garcia, Steven Weyers, Lieve Van Renterghem, Marleen Praet, Marleen Temmerman, R Velasquez, and Claude Cuvelier. 2009. “Prediction of Recurrent Disease by Cytology and HPV Testing After Treatment of Cervical Intraepithelial Neoplasia.” Cytopathology 20 (1): 27–35.
APA
AERSSENS, A., Claeys, P., BEERENS, E., Garcia, A., Weyers, S., Van Renterghem, L., Praet, M., et al. (2009). Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia. CYTOPATHOLOGY, 20(1), 27–35.
Vancouver
1.
AERSSENS A, Claeys P, BEERENS E, Garcia A, Weyers S, Van Renterghem L, et al. Prediction of recurrent disease by cytology and HPV testing after treatment of cervical intraepithelial neoplasia. CYTOPATHOLOGY. 2009;20(1):27–35.
MLA
AERSSENS, ANNELIES, Patricia Claeys, ELISABETH BEERENS, et al. “Prediction of Recurrent Disease by Cytology and HPV Testing After Treatment of Cervical Intraepithelial Neoplasia.” CYTOPATHOLOGY 20.1 (2009): 27–35. Print.