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Risk factors for type-specific persistence of high-risk human papillomavirus and residual/recurrent cervical intraepithelial neoplasia after surgical treatment

Obstetrics & Gynecology Science 2020년 63권 5호 p.631 ~ 642
오영택, 조현웅, 김성민, 민경진, 이상훈, 송재윤, 이재관, 이낙우, 홍진화,
소속 상세정보
오영택 ( Ouh Yung-Taek ) - Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
조현웅 ( Cho Hyun-Woong ) - Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
김성민 ( Kim Seong-Min ) - CHA University CHA Ilsan Medical Center Department of Obstetrics and Gynecology
민경진 ( Min Kyung-Jin ) - Korea University College of Medicine Korea University Ansan Hospital Department of Obstetrics and Gynecology
이상훈 ( Lee Sang-Hoon ) - Korea University College of Medicine Korea University Anam Hospital Department of Obstetrics and Gynecology
송재윤 ( Song Jae-Yun ) - Korea University College of Medicine Korea University Anam Hospital Department of Obstetrics and Gynecology
이재관 ( Lee Jae-Kwan ) - Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology
이낙우 ( Lee Nak-Woo ) - Korea University College of Medicine Korea University Ansan Hospital Department of Obstetrics and Gynecology
홍진화 ( Hong Jin-Hwa ) - Korea University College of Medicine Korea University Guro Hospital Department of Obstetrics and Gynecology

Abstract


Objective: This study aimed to investigate the clinicopathologic risk factors for type-specific persistence of high-risk human papillomavirus (hrHPV) and residual/recurrent cervical intraepithelial neoplasia (CIN) after surgical treatment.

Methods: Patients with CIN-2/3 who underwent conization or loop electrosurgical excision procedure (LEEP) at Korea University Hospital were enrolled. All patients underwent hrHPV testing and genotyping before conization or LEEP followed by both hrHPV genotyping and cytology. The significance of associations between patient characteristics and persistence of infection were assessed by multivariate logistic regression analyses.

Results: Among 398 women with pathologically confirmed CIN-2/3, 154 (38.7%) patients showed hrHPV persistence after surgical treatment. In multivariate analysis, high preoperative hrHPV load (P<0.05; odds ratio [OR], 2.063), presence of CIN-2 at treatment (P<0.01; OR, 2.732), and multiple hrHPV infections (P<0.001; OR, 4.752) were associated with hrHPV persistence. HPV 53 was the most likely to persist after treatment (24/43, 55.8%). The risk of residual/recurrent CIN-2/3 was higher in persistent infection with HPV 16 than other types (P<0.05). Menopause (P<0.001; OR, 3.969), preoperative and postoperative hrHPV load (P<0.05; OR, 2.430; P<0.05; OR, 5.351), and infection with multiple hrHPV types (P<0.05; OR, 2.345) were significantly related to residual/recurrent CIN following surgical treatment.

Conclusion: HPV load before treatment and infection with multiple hrHPV types were predictors of postoperative hrHPV persistence. HPV 53 was the type most likely to persist, but HPV 16 was the type that was most closely associated with residual/recurrent CIN-2/3.

키워드

Cervical intraepithelial neoplasia; Conization; Human papillomavirus; HPV DNA tests

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