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Effect of human papillomavirus genotype on severity and prognosis of cervical intraepithelial neoplasia.

Ku CH, Lee SH, Lee SP - Obstet Gynecol Sci (2014)

Bottom Line: Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2.The margin status proved to be the only statistically significant factor affecting PFS.The proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Objective: This study evaluated the effect of the specific human papillomavirus (HPV) genotypes on severity and prognosis in cervical intraepithelial neoplasia (CIN) patients.

Methods: The medical records of 446 patients treated with loop electrosurgical excision procedure (LEEP) were reviewed. The severity of CIN was categorized as CIN1/CIN2 versus CIN3+ including CIN3 and carcinoma in situ (CIS). HPV genotypes were categorized as 1) low risk, 2) intermediate risk, 3) high risk/HPV 16, 4) high risk/HPV 18, and 5) unclassified. Progression was defined as abnormal cytology, including atypical squamous cells, low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion. The margin status and progression free survival (PFS) by HPV genotypes were analyzed in 355 women with three months or more of post-treatment records.

Results: CIN3+ was the most common CIN type (67.7%), and high risk/HPV 16 (26.9%) was the most common genotype. Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2. Patients with high risk/HPV 18 showed the highest rate of positive margins (P < 0.01). The margin status proved to be the only statistically significant factor affecting PFS.

Conclusion: The proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group. CIN patients with high risk/HPV 18 need to be more carefully tracked than patients with the other HPV genotypes.

No MeSH data available.


Related in: MedlinePlus

Univariate analysis of progression free survival (PFS). (A) PFS was significantly lower (P < 0.01) in the positive margin group than the negative margin group. (B) Human papilloma virus (HPV) genotype had no significant effect on PFS (P = 0.19).
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Figure 1: Univariate analysis of progression free survival (PFS). (A) PFS was significantly lower (P < 0.01) in the positive margin group than the negative margin group. (B) Human papilloma virus (HPV) genotype had no significant effect on PFS (P = 0.19).

Mentions: PFS according to the status of margin and HPV genotype was analyzed in these 355 patients. In univariate analysis, only the status of margin had significant effect (P < 0.01) on PFS (Fig. 1). PFS was significantly lower in the positive margin group than the negative margin group (Fig. 1A). The slightly lower PFS observed in the high risk/HPV 18 could be explained by chance (Fig. 1B). By multivariate Cox's proportional hazard analysis, the margin status was the only statistically significant factor affecting PFS (Table 4).


Effect of human papillomavirus genotype on severity and prognosis of cervical intraepithelial neoplasia.

Ku CH, Lee SH, Lee SP - Obstet Gynecol Sci (2014)

Univariate analysis of progression free survival (PFS). (A) PFS was significantly lower (P < 0.01) in the positive margin group than the negative margin group. (B) Human papilloma virus (HPV) genotype had no significant effect on PFS (P = 0.19).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3924743&req=5

Figure 1: Univariate analysis of progression free survival (PFS). (A) PFS was significantly lower (P < 0.01) in the positive margin group than the negative margin group. (B) Human papilloma virus (HPV) genotype had no significant effect on PFS (P = 0.19).
Mentions: PFS according to the status of margin and HPV genotype was analyzed in these 355 patients. In univariate analysis, only the status of margin had significant effect (P < 0.01) on PFS (Fig. 1). PFS was significantly lower in the positive margin group than the negative margin group (Fig. 1A). The slightly lower PFS observed in the high risk/HPV 18 could be explained by chance (Fig. 1B). By multivariate Cox's proportional hazard analysis, the margin status was the only statistically significant factor affecting PFS (Table 4).

Bottom Line: Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2.The margin status proved to be the only statistically significant factor affecting PFS.The proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Gachon University Gil Medical Center, Incheon, Korea.

ABSTRACT

Objective: This study evaluated the effect of the specific human papillomavirus (HPV) genotypes on severity and prognosis in cervical intraepithelial neoplasia (CIN) patients.

Methods: The medical records of 446 patients treated with loop electrosurgical excision procedure (LEEP) were reviewed. The severity of CIN was categorized as CIN1/CIN2 versus CIN3+ including CIN3 and carcinoma in situ (CIS). HPV genotypes were categorized as 1) low risk, 2) intermediate risk, 3) high risk/HPV 16, 4) high risk/HPV 18, and 5) unclassified. Progression was defined as abnormal cytology, including atypical squamous cells, low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion. The margin status and progression free survival (PFS) by HPV genotypes were analyzed in 355 women with three months or more of post-treatment records.

Results: CIN3+ was the most common CIN type (67.7%), and high risk/HPV 16 (26.9%) was the most common genotype. Intermediate risk (P < 0.01), high risk/HPV 16 (P < 0.01) and high risk/HPV 18 (P < 0.01) were significantly more common in women with CIN3+ than CIN1/CIN2. Patients with high risk/HPV 18 showed the highest rate of positive margins (P < 0.01). The margin status proved to be the only statistically significant factor affecting PFS.

Conclusion: The proportion of positive margins was significantly different by HPV genotypes and highest in high risk/HPV 18 group. CIN patients with high risk/HPV 18 need to be more carefully tracked than patients with the other HPV genotypes.

No MeSH data available.


Related in: MedlinePlus