Factors associated with recurrence of cervical intraepithelial neoplasia after conization in HIV-infected and noninfected women
- 202 Downloads
To identify risk factors associated with recurrence of cervical intraepithelial neoplasia (CIN) following loop electrosurgical excision procedures in women with and without human immunodeficiency virus (HIV).
A total of 33 patients with recurrent CIN and 105 without recurrence were contrasted using a nested case–control design. The patients were enrolled between 1999 and 2004. Recurrence diagnosis was established after conization, and tissues were fixed in formalin and embedded in paraffin. Polymerase chain reaction was used to detect the human papillomavirus genome (HPV DNA) types 6, 11, 16, 18, 31, 33, and 35. Statistical analysis was performed using χ2 test with Yates correction and the Fisher’s exact test for comparison of categorical variables. Multivariate analysis was carried out using logistic regression models.
Human immunodeficiency virus infection (p = 0.001), glandular involvement (p = 0.000), and compromised margins (p = 0.02) were significantly associated with CIN recurrence. HPV DNA was positive in 57.6% of patients with CIN recurrence. High-risk HPV subtypes were detected in most cases but were not associated with recurrence (p = 0.27). In multivariate analysis, HIV infection and glandular involvement were independently associated with CIN recurrence.
Human immunodeficiency virus infection and glandular involvement are associated with CIN recurrence.
KeywordsCervical intraepithelial neoplasia Human immunodeficiency virus Loop electrosurgical excision procedure Recurrence Human papillomavirus
Conflict of interest
The authors declare that they have no conflict of interest.
- 9.Prato B, Ghelardi A, Gadducci A, Marchetti I, Di Cristofano C, Di Coscio G et al (2008) Correlation of recurrence rates and times with posttreatment human papillomavirus status in patients treated with loop electrosurgical excision procedure conization for cervical squamous intraepithelial lesions. Int J Gynecol Cancer 18:90–94PubMedCrossRefGoogle Scholar
- 13.Verguts J, Bronselaer B, Donders G, Arbyn M, Van Eldere J, Drijkoningen M, Poppe W (2006) Prediction of recurrence after treatment for high-grade cervical intraepithelial neoplasia: the role of human papillomavirus testing and age at conization. Int J Obstet Gynaecol 113:1303–1307Google Scholar
- 18.Nappi L, Carriero C, Bettocchi S, Herrero J, Vimercati A, Putignano G (2005) Cervical squamous intraepithelial lesions of low-grade in HIV-infected women: recurrence, persistence and progression, in treated and untreated women. Eur J Obstet Gynecol Reprod Biol 121:226–232PubMedCrossRefGoogle Scholar
- 19.Walker P, Dexeus S, de Palo G, Barrasso R, Campion M, Girardi F et al (2009) International terminology of colposcopy: an updated report from the international federation for cervical pathology and colposcopy. Available at: http://www.ifcpc.org/ifcpc/terminology.htm. Accessed: 12 Sep 2009