Skip to main content
SpringerLink
Log in

The negative conversion of high-risk human papillomavirus and its performance in surveillance of cervical cancer after treatment: a retrospective study

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

To determine the negative conversion regularity of high-risk human papillomavirus (HR-HPV) and to evaluate the prognostic implications of HR-HPV testing in patients with cervical cancer after treatment.

Methods

A retrospective post-treatment analysis of 173 patients with cervical cancer was performed from January 2011 to December 2012. Patients who had HR-HPV infection before treatment were included. Clinical and pathological characteristics, as well as follow-up information, were reviewed.

Results

The negative conversion rate of HR-HPV reached 68.9 % within half a year and increased most rapidly within the first 2 years after treatment. Univariate and multivariate analyses suggested that the negative conversion rate of HR-HPV was significantly correlated with clinical stage, treatment regimens, and HR-HPV type (P < 0.05). In our analysis of 173 patients, we found that HR-HPV status was predictive of 3-year survival rate and disease recurrence (P < 0.05). Pelvic recurrence, but not distant metastasis, was influenced by HR-HPV status (P < 0.05). Through 2 × 2 table analysis, we found that HR-HPV was more sensitive (71.43 %) and specific (94.20 %) than cervical cytology (sensitivity 62.86 % and specificity 78.26 %).

Conclusions

The negative conversion rate of HR-HPV increased most rapidly within the first 2 years of cervical cancer surveillance. Persistent HPV infection was associated with a poor prognosis and had an impact on recurrence sites. Further large and multi-center prospective studies should be performed, but these results of this study suggested that HR-HPV monitoring is necessary to be used as a means of cervical cancer surveillance.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Dikshit R, Eser S, Mathers C, Rebelo M, Parkin DM, Forman D, Bray F (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer 136:E359–E386

    Article  CAS  PubMed  Google Scholar 

  2. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, Jemal A, Yu XQ, He J (2016) Cancer statistics in China, 2015. CA Cancer J Clin 66:115–132

    Article  PubMed  Google Scholar 

  3. Siegel RL, Miller KD, Jemal A (2016) Cancer statistics, 2016. CA Cancer J Clin 66:7–30

    Article  PubMed  Google Scholar 

  4. Khalil J, El Kacemi H, Afif M, Kebdani T, Benjaafar N (2015) Five years’ experience treating locally advanced cervical cancer with concurrent chemoradiotherapy: results from a single institution. Arch Gynecol Obstet 292:1091–1099

    Article  CAS  PubMed  Google Scholar 

  5. Siegel R, Naishadham D, Jemal A (2013) Cancer statistics, 2013. CA Cancer J Clin 63:11–30

    Article  PubMed  Google Scholar 

  6. Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A (2015) Global cancer statistics, 2012. CA Cancer J Clin 65:87–108

    Article  PubMed  Google Scholar 

  7. Bernard HU, Burk RD, Chen Z, van Doorslaer K, zur Hausen H, de Villiers EM (2010) Classification of papillomaviruses (PVs) based on 189 PV types and proposal of taxonomic amendments. Virology 401:70–79

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Muñoz N, Bosch FX, de Sanjosé S, Herrero R, Castellsagué X, Shah KV, Snijders PJ, Meijer CJ (2003) International Agency for Research on Cancer Multicenter Cervical Cancer Study Group. Epidemiologic classification of human papillomavirus types associated with cervical cancer. N Engl J Med 348:518–527

    Article  PubMed  Google Scholar 

  9. Kamal EM, El Sayed GA, El Behery MM, El Shennawy GA (2014) HPV detection in a self-collected vaginal swab combined with VIA for cervical cancer screening with correlation to histologically confirmed CIN. Arch Gynecol Obstet 290:1207–1213

    Article  PubMed  Google Scholar 

  10. Denny L, Boa R, Williamson AL, Allan B, Hardie D, Stan R, Myer L (2008) Human papillomavirus infection and cervical disease in human immunodeficiency virus-1-infected women. Obstet Gynecol 111:1380–1387

    Article  PubMed  Google Scholar 

  11. Bae JH, Lee SJ, Kim CJ, Hur SY, Park YG, Lee WC, Kim YT, Ng TL, Bock HL, Park JS (2008) Human papillomavirus (HPV) type distribution in Korean women: a meta-analysis. J Microbiol Biotechnol 18:788–794

    PubMed  Google Scholar 

  12. Das P, Thomas A, Mahantshetty U, Shrivastava SK, Deodhar K, Mulherkar R (2012) HPV genotyping and site of viral integration in cervical cancers in Indian women. PLoS One 7:e41012

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Gizzo S, Ancona E, Patrelli TS, Saccardi C, Anis O, Donato D, Nardelli GB (2013) Fertility preservation in young women with cervical cancer: an oncologic dilemma or a new conception of fertility sparing surgery? Cancer Invest 31:189

    Article  PubMed  Google Scholar 

  14. Das P, Thomas A, Kannan S, Deodhar K, Shrivastava SK, Mahantshetty U, Mulherkar R (2015) Human papillomavirus (HPV) genome status and cervical cancer outcome—a retrospective study. Indian J Med Res 142:525–532

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Agapova M, Duignan A, Smith A, O’Neill C, Basu A (2015) Long-term costs of introducing HPV-DNA post-treatment surveillance to national cervical cancer screening in Ireland. Expert Rev Pharmacoecon Outcomes Res 15:999–1005

    Article  PubMed  Google Scholar 

  16. Smith MA, Gertig D, Hall M, Simms K, Lew JB, Malloy M, Saville M, Canfell K (2016) Transitioning from cytology-based screening to HPV-based screening at longer intervals: implications for resource use. BMC Health Serv Res 16:147

    Article  PubMed  PubMed Central  Google Scholar 

  17. Hillemanns P (2016) The paradigm shift in cervical cancer screening in Germany. Arch Gynecol Obstet 293(1):3–4

    Article  PubMed  Google Scholar 

  18. Elit L, Kennedy EB, Fyles A, Metser U (2016) Follow-up for cervical cancer: a Program in Evidence-Based Care systematic review and clinical practice guideline update. Curr Oncol 23:109–118

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Salani R, Backes FJ, Fung MF, Holschneider CH, Parker LP, Bristow RE, Goff BA (2011) Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies: society of Gynecologic Oncologists recommendations. Am J Obstet Gynecol 204:466–478

    Article  PubMed  Google Scholar 

  20. Intharaburan S, Tanapat Y, Tatanan K, Sangkhavasi K, Komolpis S, Buranawit K, Jarruwale P (2012) Human papillomavirus infection following radiation therapy or concurrent chemoradiation for invasive cervical cancer. J Med Assoc Thai 95:S38–S41

    PubMed  Google Scholar 

  21. Brand RA (2009) Standards of reporting: the CONSORT, QUORUM, and STROBE guidelines. Clin Orthop Relat Res 467:1393–1394

    Article  PubMed  PubMed Central  Google Scholar 

  22. Boehmer G, Wang L, Iftner A, Holz B, Haedicke J, von Wasielewski R, Martus P, Iftner T (2014) A population-based observational study comparing Cervista and Hybrid Capture 2 methods: improved relative specificity of the Cervista assay by increasing its cut-off. BMC Infect Dis 14:674

    Article  PubMed  PubMed Central  Google Scholar 

  23. Silva J, Cerqueira F, Medeiros R (2014) Chlamydia trachomatis infection: implications for HPV status and cervical cancer. Arch Gynecol Obstet 289:715–723

    Article  PubMed  Google Scholar 

  24. Plummer M, Schiffman M, Castle PE, Maucort-Boulch D, Wheeler CM, ALTS Group (2007) A 2-year prospective study of human papillomavirus persistence among women with a cytological diagnosis of atypical squamous cells of undetermined significance or low-grade squamous intraepithelial lesion. J Infect Dis 195:1582–1589

    Article  PubMed  Google Scholar 

  25. Ryu A, Nam K, Kwak J, Kim J, Jeon S (2012) Early human papillomavirus testing predicts residual/recurrent disease after LEEP. J Gynecol Oncol 23:217–225

    Article  PubMed  PubMed Central  Google Scholar 

  26. Kim CJ, Lee YS, Kwack HS, Yoon WS, Park TC, Park JS (2010) Specific human papillomavirus types and other factors on the risk of cervical intraepithelial neoplasia: a case-control study in Korea. Int J Gynecol Cancer 20:1067–1073

    Article  PubMed  Google Scholar 

  27. Nam K, Chung S, Kim J, Jeon S, Bae D (2009) Factors associated with HPV persistence after conization in patients with negative margins. J Gynecol Oncol 20:91–95

    Article  PubMed  PubMed Central  Google Scholar 

  28. Hu D, Zhou J, Wang F, Shi H, Li Y, Li B (2015) HPV-16 E6/E7 promotes cell migration and invasion in cervical cancer via regulating cadherin switch in vitro and in vivo. Arch Gynecol Obstet 292:1345–1354

    Article  CAS  PubMed  Google Scholar 

  29. Lagos M, Van De Wyngard V, Poggi H, Cook P, Viviani P, Barriga MI, Pruyas M, Ferreccio C (2015) HPV16/18 genotyping for the triage of HPV positive women in primary cervical cancer screening in Chile. Infect Agent Cancer 10:43

    Article  PubMed  PubMed Central  Google Scholar 

  30. Yu MC, Austin RM, Lin J, Beck T, Beriwal S, Comerci JT, Edwards RP, Sukumvanich P, Kelley J, Olawaiye AB (2015) The role of high-risk human Papilloma virus testing in the surveillance of cervical cancer after treatment. Arch Pathol Lab Med 139:1437–1440

    Article  PubMed  Google Scholar 

  31. Costa S, Venturoli S, Origoni M, Preti M, Mariani L, Cristoforoni P, Sandri MT (2015) Performance of HPV DNA testing in the follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ (AIS) and microinvasive carcinoma. Ecancermedicalscience 9:528

    Article  PubMed  PubMed Central  Google Scholar 

  32. Park JY, Bae J, Lim MC, Lim SY, Lee DO, Kang S, Park SY, Nam BH, Seo SS (2009) Role of high risk-human papilloma virus test in the follow-up of patients who underwent conization of the cervix for cervical intraepithelial neoplasia. J Gynecol Oncol 20:86–90

    Article  PubMed  PubMed Central  Google Scholar 

  33. Song YJ, Kim JY, Lee SK, Lim HS, Lim MC, Seo SS, Kang S, Lee DO, Park SY (2011) Persistent human papillomavirus DNA is associated with local recurrence after radiotherapy of uterine cervical cancer. Int J Cancer 129:896–902

    Article  CAS  PubMed  Google Scholar 

  34. Origoni M, Cristoforoni P, Costa S, Mariani L, Scirpa P, Lorincz A, Sideri M (2012) HPV-DNA testing for cervical cancer precursors: from evidence to clinical practice. Ecancermedicalscience 6:258

    CAS  PubMed  PubMed Central  Google Scholar 

  35. Noventa M, Ancona E, Cosmi E, Saccardi C, Litta P, D’Antona D, Nardelli GB, Gizzo S (2014) Usefulness, methods and rationale of lymph nodes HPV-DNA investigation in estimating risk of early stage cervical cancer recurrence: a systematic literature review. Clin Exp Metastasis 31:853–867

    Article  CAS  PubMed  Google Scholar 

  36. Deng T, Feng Y, Zheng J, Huang Q, Liu J (2015) Low initial human papillomavirus viral load may indicate worse prognosis in patients with cervical carcinoma treated with surgery. J Gynecol Oncol 26:111–117

    Article  PubMed  PubMed Central  Google Scholar 

  37. Kocken M, Helmerhorst TJ, Berkhof J, Louwers JA, Nobbenhuis MA, Bais AG, Hogewoning CJ, Zaal A, Verheijen RH, Snijders PJ, Meijer CJ (2011) Risk of recurrent high-grade cervical intraepithelial neoplasia after successful treatment: a long-term multi-cohort study. Lancet Oncol 12:441–450

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Gynecological Oncology, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China

    Dan Song, Wei-min Kong, Tong-qing Zhang, Si-meng Jiao, Jiao Chen, Chao Han & Ting-ting Liu

Authors
  1. Dan Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Wei-min Kong
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tong-qing Zhang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Si-meng Jiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Jiao Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Chao Han
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Ting-ting Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Wei-min Kong.

Ethics declarations

Conflict of interest

All the authors declare that they have no potential conflicts of interest.

Ethical approval

For this type of study, formal consent is not required, and this article does not contain any studies with animals performed by any of the authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Song, D., Kong, Wm., Zhang, Tq. et al. The negative conversion of high-risk human papillomavirus and its performance in surveillance of cervical cancer after treatment: a retrospective study. Arch Gynecol Obstet 295, 197–203 (2017). https://doi.org/10.1007/s00404-016-4197-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00404-016-4197-4

Keywords

Search

Navigation