Recurrent high-grade cervical lesion after primary conization is associated with persistent human papillomavirus infection in Norway
| Autor: | S. Thoresen, Dominique Rosillon, Ole Erik Iversen, S. de Souza, Wim Quint, Katsiaryna Holl, Olav Karsten Vintermyr, Anco Molijn |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Conization Uterine Cervical Neoplasms Cervical lesion Alphapapillomavirus Cervical intraepithelial neoplasia Recurrent disease medicine Humans Registries Human papillomavirus Aged Retrospective Studies Gynecology Human papillomavirus 16 Human papillomavirus 18 Hpv types Norway business.industry Papillomavirus Infections HPV infection Obstetrics and Gynecology Histology Sequence Analysis DNA Middle Aged Uterine Cervical Dysplasia medicine.disease female genital diseases and pregnancy complications Hpv testing Oncology DNA Viral Female Neoplasm Recurrence Local business |
| Zdroj: | Gynecologic Oncology. 133:159-166 |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2014.03.004 |
| Popis: | Objective This retrospective registry-based study aimed to assess the human papillomavirus (HPV)-type distribution in primary and recurrent high-grade cervical intraepithelial neoplasia (CIN2+), and to discriminate pre-existing from newly-acquired infections. Methods Cervical specimens from 58 women (median age (Q1–Q3): 37.6 (31.7–44.9)) who underwent primary (1998–2003) and repeat conizations were confirmed as CIN2+ during expert pathology review. HPV testing was performed using PCR MP-TS123 Luminex for 16 HPV types. Molecular HPV16 E6 and HPV18 LCR DNA sequencing was performed on specimens with persistent HPV16/18. Results All 58 paired cones were HPV positive; 49 had CIN3+ in the primary cone. Forty-seven (95.9%) women with primary CIN3+ and recurrent CIN2+ had persistent high-risk ( hr ) HPV infection, of which 74.5% were HPV16/18. Two women had probable newly-acquired HPV16/52/56 and HPV39 infections. One woman with persistent HPV52 also had a probable new HPV16 E6 variant in the recurrent CIN2+. Median time delay (Q1–Q3) between conizations was 2.0years (1.1–4.0), being shorter for women older than 40years: 2.6years (1.1–3.7) than for women younger than 40years: 6.0years (2.0–8.7). Primary conization histology revealed CIN3, cervical adenocarcinoma in situ and microinvasive carcinomas in 43 (87.8%), 5 (10.2%) and 1 (2.0%) women, respectively. Primary HPV16- and HPV18-infected CIN3+ had a shorter delay between conizations: 1.8years (1.2–4.4) and 2.2years (0.4–NE), respectively, compared to HPV33-: 3.8years (3.3–7.8) or other HPV type-infected: 8.2years (6.0–NE) CIN3+. Conclusions Routine post-conization hr- HPV DNA testing together with cervical cytology may provide a better prediction for potential recurrent disease. Further, primary prevention through adolescent vaccination may prevent CIN2+ and its recurrence. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect