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Evaluation of the intraoperative human papillomavirus test as a marker of early cure at 12 months after electrosurgical excision procedure in women with cervical high‐grade squamous intraepithelial lesion: a prospective cohort study
Author(s) -
Rabasa J,
Bradbury M,
SanchezIglesias JL,
Guerrero D,
Forcada C,
Alcalde A,
PérezBenavente A,
Cabrera S,
Ramon y Cajal S,
Hernandez J,
Dinares C,
García A,
Centeno C,
GilMoreno A
Publication year - 2020
Publication title -
bjog: an international journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.157
H-Index - 164
eISSN - 1471-0528
pISSN - 1470-0328
DOI - 10.1111/1471-0528.15932
Subject(s) - medicine , squamous intraepithelial lesion , prospective cohort study , cohort , cervical intraepithelial neoplasia , human papillomavirus , genotyping , surgery , cervical cancer , gynecology , genotype , cancer , biochemistry , chemistry , gene
Objective To evaluate if the intraoperative human papillomavirus ( IOP ‐ HPV ) test has the same prognostic value as the HPV test performed at 6 months after treatment of high‐grade squamous intraepithelial lesion ( HSIL ) to predict treatment failure. Design Prospective cohort study. Setting Barcelona, Spain. Population A cohort of 216 women diagnosed with HSIL and treated with loop electrosurgical excision procedure ( LEEP ). Methods After LEEP , an HPV test was performed using the Hybrid Capture 2 system. If this was positive, genotyping was performed with the CLART HPV 2 technique. The IOP ‐ HPV test was compared with HPV test at 6 months and with surgical margins. Main outcome measure Treatment failure. Results Recurrence rate of HSIL was 6%. There was a strong association between a positive IOP ‐ HPV test, a positive 6‐month HPV test, positive HPV 16 genotype, positive surgical margins and HSIL recurrence. Sensitivity, specificity, and positive and negative predictive values of the IOP ‐ HPV test were 85.7, 80.8,24.0 and 98.8% and of the HPV test at 6 months were 76.9, 75.8, 17.2 and 98.0%. Conclusion Intraoperative HPV test accurately predicts treatment failure in women with cervical intraepithelial neoplasia grade 2/3. This new approach may allow early identification of patients with recurrent disease, which will not delay the treatment. Genotyping could be useful in detecting high‐risk patients. Tweetable abstract IOP ‐ HPV test accurately predicts treatment failure in women with CIN 2/3.