Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand

Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persis...

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Main Authors: Surapan Khunamornpong, Jongkolnee Settakorn, Kornkanok Sukpan, Chumnan Kietpeerakool, Charuwan Tantipalakorn, Prapaporn Suprasert, Sumalee Siriaunkgul
Format: Journal
Published: 2018
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http://cmuir.cmu.ac.th/jspui/handle/6653943832/54175
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Institution: Chiang Mai University
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spelling th-cmuir.6653943832-541752018-09-04T10:23:15Z Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand Surapan Khunamornpong Jongkolnee Settakorn Kornkanok Sukpan Chumnan Kietpeerakool Charuwan Tantipalakorn Prapaporn Suprasert Sumalee Siriaunkgul Biochemistry, Genetics and Molecular Biology Medicine Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persistent or recurrent disease after LEEP in patients with cervical epithelial lesions in northern Thailand. Materials and Methods: Patients who underwent LEEP as a treatment for histological low-grade (LSIL) or high-grade squamous intraepithelial lesion (HSIL) or worse at Chiang Mai University Hospital between June 2010 and May 2012 were included. Follow-ups were scheduled at 6-month intervals and continued for 2 years using co-testing (liquid-based cytology and Hybrid Capture 2 [HC2]) at 6 months and 24 months and liquid-based cytology alone at 12 and 18 months. Results: Of 98 patients included, the histological diagnoses for LEEP included LSIL in 16 patients, and HSIL or worse in 82 patients. The LEEP margin status was negative in 84 patients (85.7%). At follow-up, 10 patients (10.2%) had persistent/recurrent lesions; 4 among LSIL patients (25.0%) and 6 in the group with HSIL or worse (7.3%). Only 2 of 82 patients (2.4%) with HSIL or worse diagnoses had histological HSIL in the persistent/recurrent lesions. Using histologically confirmed LSIL as the threshold for the detection of persistent/recurrent disease, cytology had a higher sensitivity than HC2 (90.0% versus 70.0%). At the 6-month follow-up appointment, combined cytology and HC2 (co-testing) had a higher sensitivity in predicting persistent/recurrent disease (80.0%) compared with that of cytology alone (70.0%) and HC2 (50.0%). Conclusions: After LEEP with a negative surgical margin, the rate of persistent/recurrent lesions is low. The addition of HPV testing at the 6-month visit to the usual cytology schedule may be an effective approach in the follow-up after LEEP. 2018-09-04T10:08:59Z 2018-09-04T10:08:59Z 2015-01-01 Journal 15137368 2-s2.0-84944208359 10.7314/APJCP.2015.16.14.6093 https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84944208359&origin=inward http://cmuir.cmu.ac.th/jspui/handle/6653943832/54175
institution Chiang Mai University
building Chiang Mai University Library
country Thailand
collection CMU Intellectual Repository
topic Biochemistry, Genetics and Molecular Biology
Medicine
spellingShingle Biochemistry, Genetics and Molecular Biology
Medicine
Surapan Khunamornpong
Jongkolnee Settakorn
Kornkanok Sukpan
Chumnan Kietpeerakool
Charuwan Tantipalakorn
Prapaporn Suprasert
Sumalee Siriaunkgul
Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
description Background: HPV DNA testing has been recently introduced as an adjunct test to cytology in the follow-up of patients after treatment for cervical lesions using the loop electrosurgical excision procedure (LEEP). The aim of this study was to evaluate the role of HPV testing in the detection of persistent or recurrent disease after LEEP in patients with cervical epithelial lesions in northern Thailand. Materials and Methods: Patients who underwent LEEP as a treatment for histological low-grade (LSIL) or high-grade squamous intraepithelial lesion (HSIL) or worse at Chiang Mai University Hospital between June 2010 and May 2012 were included. Follow-ups were scheduled at 6-month intervals and continued for 2 years using co-testing (liquid-based cytology and Hybrid Capture 2 [HC2]) at 6 months and 24 months and liquid-based cytology alone at 12 and 18 months. Results: Of 98 patients included, the histological diagnoses for LEEP included LSIL in 16 patients, and HSIL or worse in 82 patients. The LEEP margin status was negative in 84 patients (85.7%). At follow-up, 10 patients (10.2%) had persistent/recurrent lesions; 4 among LSIL patients (25.0%) and 6 in the group with HSIL or worse (7.3%). Only 2 of 82 patients (2.4%) with HSIL or worse diagnoses had histological HSIL in the persistent/recurrent lesions. Using histologically confirmed LSIL as the threshold for the detection of persistent/recurrent disease, cytology had a higher sensitivity than HC2 (90.0% versus 70.0%). At the 6-month follow-up appointment, combined cytology and HC2 (co-testing) had a higher sensitivity in predicting persistent/recurrent disease (80.0%) compared with that of cytology alone (70.0%) and HC2 (50.0%). Conclusions: After LEEP with a negative surgical margin, the rate of persistent/recurrent lesions is low. The addition of HPV testing at the 6-month visit to the usual cytology schedule may be an effective approach in the follow-up after LEEP.
format Journal
author Surapan Khunamornpong
Jongkolnee Settakorn
Kornkanok Sukpan
Chumnan Kietpeerakool
Charuwan Tantipalakorn
Prapaporn Suprasert
Sumalee Siriaunkgul
author_facet Surapan Khunamornpong
Jongkolnee Settakorn
Kornkanok Sukpan
Chumnan Kietpeerakool
Charuwan Tantipalakorn
Prapaporn Suprasert
Sumalee Siriaunkgul
author_sort Surapan Khunamornpong
title Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
title_short Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
title_full Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
title_fullStr Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
title_full_unstemmed Application of HPV DNA testing in follow-up after loop electrosurgical excision procedures in Northern Thailand
title_sort application of hpv dna testing in follow-up after loop electrosurgical excision procedures in northern thailand
publishDate 2018
url https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=84944208359&origin=inward
http://cmuir.cmu.ac.th/jspui/handle/6653943832/54175
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