Intraoperative Human Papillomavirus Test Predicts 24-Month High-Grade Squamous Intraepithelial Lesion Recurrence Saving Costs: A Prospective Cohort Study
| Autor: | Assumpció Pérez-Benavente, Diana Guerrero, Silvia Cabrera, Jose Luis Sánchez-Iglesias, Cristina Centeno, Javier Hernandez, Antonio Gil-Moreno, Ana Alcalde, Santiago Ramón y Cajal, Angel Garcia, Cristina Forcada, Melissa Bradbury, Jordi Rabasa |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
medicine.medical_specialty Alphapapillomavirus Endocervical curettage Cervical intraepithelial neoplasia Sensitivity and Specificity Time Cohort Studies Lesion Young Adult Internal medicine Biopsy Humans Medicine Prospective Studies Human papillomavirus Prospective cohort study Papillomaviridae medicine.diagnostic_test business.industry virus diseases Obstetrics and Gynecology General Medicine Middle Aged Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Test (assessment) Squamous intraepithelial lesion Spain Female Squamous Intraepithelial Lesions of the Cervix Neoplasm Recurrence Local medicine.symptom business Follow-Up Studies Papanicolaou Test |
| Zdroj: | Journal of Lower Genital Tract Disease. 24:367-371 |
| ISSN: | 1526-0976 |
| DOI: | 10.1097/lgt.0000000000000549 |
| Popis: | Objectives The human papilloma virus (HPV) test is recommended in the posttreatment follow-up of cervical intraepithelial neoplasia. The aim of the study was to assess whether the intraoperative HPV (IOP-HPV) test had a similar diagnostic accuracy that HPV test performed at 6 months to predict high-grade squamous intraepithelial lesion (HSIL) recurrence. Materials and methods In a prospective cohort study, 304 women diagnosed with HSIL by biopsy and/or endocervical curettage before treatment and/or confirmation in the histological specimen were included. Immediately after surgery, HPV testing was performed. This test was compared with the test at 6 months and other predictors of recurrence. Patients were followed for 24 months. An economic analysis was performed to compare the costs of IOP-HPV and HPV test at 6 months. Results Recurrence rate of HSIL was 6.2% (19 patients). The diagnostic accuracy of the IOP-HPV test to predict HSIL recurrence at 24 months was similar to the HPV test at 6 months, with comparative sensitivities of 100% versus 86.7%, specificities of 82.0% versus 77.9%, positive predictive values of 27.1% versus 18.1%, and negative predictive values of 100% versus 99.0%. Direct economic saving per high-grade intraepithelial lesion patient was 172.8 O. Conclusions The HPV test performed after loop electrosurgical resection procedure predicted recurrence of HSIL at 24 months with a similar diagnostic accuracy than the HPV test at 6 months. The use of the IOP-HPV test in the management of HSIL will allow early detection of the risk of recurrent disease and to save costs because of potential suppression of the need of HPV and follow-up controls at 6 months. |
| Databáze: | OpenAIRE |
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