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

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.