Evaluation of the Combination of Cytology and Hybrid Capture to Safely Predict the High-Grade Lesion Status of Patients Treated with Conization with Large Loop Excision of the Transformation Zone

Abstract

Objectives: This study aimed to verify whether human papillomavirus (HPV) testing after conization treatment has some potential usefulness for predicting patients’ outcome. Study Design: One hundred and twenty women were treated for HSIL by conization with large loop excision of the transformation zone (LLETZ). Cytology, colposcopy-guided biopsy, and hybrid capture 2 (HC2) HPV DNA tests were performed before the surgical procedure and every 6 months for 2 years at follow-up. Results: More than 90% of the patients tested positive for high-risk HPV prior to the surgical intervention. Six months after the cervical conization, 74.75% of the patients tested negative for high-risk HPV DNA, and 19.41% were positive. Of the women who were HC2 negative, 72 showed normal cytological smears, 3 ASC-US, 2 LSIL, and 1 HSIL. Of those who were HC2 positive, 8 showed normal smears, 2 ASC-US, 2 ASC-H, 5 LSIL, and 1 case had HSIL, AGC, and squamous cells invasive carcinoma. Clinically, the HSIL case with a negative HPV test did not show any sign of high-grade lesions, and the clinical follow-up did not show residual lesions. Conclusions: Negative HPV tests correlated with freedom from high-grade disease after 2 years of postconization follow-up, which strongly suggests that negative HPV tests predict the absence of cervical disease.

Characterization of p16 and E6 HPV-related proteins in uterine cervix high-grade lesions of patients treated by conization with large loop excision

“…The results of the present study supported the use of the HC2 HPV DNA test, collected in the first post-operative assessment, as a marker of disease recurrence or a disease-free status (11). Additionally, the results demonstrated that the characterization of p16 in a well-controlled population that underwent cervix conization due to the HSIL alteration was concordant with previous results.…”

“…In our previous study, containing partial information from the present study, we identified that patients with a combination of negative cytology and negative hybrid capture test results did not exhibit high-grade lesions at the conization follow-up examination (11). The results of the present study supported the use of the HC2 HPV DNA test, collected in the first post-operative assessment, as a marker of disease recurrence or a disease-free status (11).…”

Intraoperative post‐conisation human papillomavirus testing for early detection of treatment failure in patients with cervical intraepithelial neoplasia: a pilot study

“…Most precancerous lesions arise at the transformation zone, and it has been shown that after excision of the lesion and the transformation zone a high percentage of women clear not only the lesion but also the infection, and become negative for HPV . This suggests that the HPV infection is mainly limited to the lesion and the transformation zone.…”

Detecção de DNA de HPV no plasma para potencial identificação precoce de recidiva de câncer do colo de útero

“…Atualmente, a IARC (Agência Internacional para Pesquisa de Câncer) divide os HPVs em de baixo risco oncogênico (HPV-6, 11, 40, 42, 43, 44, 54, 61, 70, 72 e 81) e de alto risco oncogênico (HPV- 16,18,31,33,35,39,45,51,52,56,58,59,68, 73 e 82) de acordo com a sua capacidade de gerar neoplasias malignas (14) . Os tipos HPV- 26,53,66,67,68,70, 73 e 82 são classificados como genótipos de provável alto risco (14,31,32) . (19) .…”

“…(67) . Outro estudo de Roncaglia et al (68) avaliou se o teste de HPV (captura híbrida) após tratamento com conização em pacientes com diagnóstico de neoplasia intraepitelial cervical de alto grau (NIC II e III) tinha alguma utilidade potencial para predizer a resposta da paciente ao tratamento, isto é, se havia a presença de doença residual ou recidiva e verificaram que o teste de HPV negativo foi correlacionado com a ausência de lesão de alto grau após dois anos de seguimento pós-conização, o que fortemente sugere que um teste HPV negativo prediz a ausência de doença cervical (68) .…”