Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb 28;14(5):509.
doi: 10.3390/diagnostics14050509.

Correlation of the HPV 16 Genotype Persistence in Women Undergoing LEEP for CIN3 with the Risk of CIN2+ Relapses in the First 18 Months of Follow-Up: A Multicenter Retrospective Study

Maria Teresa Bruno  1   2 , Gaetano Valenti  2   3 , Zaira Ruggeri  4 , Giosuè Giordano Incognito  1 , Paola Coretti  1 , Giuseppe Dario Montana  1 , Marco Marzio Panella  1   2 , Liliana Mereu  1
Affiliations

Correlation of the HPV 16 Genotype Persistence in Women Undergoing LEEP for CIN3 with the Risk of CIN2+ Relapses in the First 18 Months of Follow-Up: A Multicenter Retrospective Study

Maria Teresa Bruno et al. Diagnostics (Basel). .

Abstract

Objective: Specific hr-HPV genotypes have different natural histories and different oncogenic capacity. This study aimed to investigate the risk of CIN2+ recurrence of the individual genotypes and evaluate how the duration of HPV persistence influences the risk of developing recurrent 16 cervical dysplasia of high grade (CIN2+).

Methods: Data from patients with persistent HPV infection after primary conization were retrospectively extracted. Kaplan-Meier proportional hazards models were used to evaluate associations between the duration of HPV persistence and the risk of developing recurrent CIN2+. Kruskal-Wallis testing with Dunn's multiple comparison test was used to test whether there was a statistically significant difference in the time to development of tumor recurrences between different genotypes.

Results: Overall, 333 patients met the inclusion criteria. In 285 cases the HPV infection was persistent, in 48 cases (18%) it was transient, i.e., different genotypes after LEEP. Overall were diagnosed 39 relapses (13.7%), 79.5% (31/39 cases) were due to genotype 16, 20.5% (8/39) were linked to the other genotypes. Persistence of genotype 16 showed a 7-fold increased risk of developing a CIN2+ relapse, OR = 7.08 (95%CI: 3.12-16.08). Furthermore, the majority of relapses (38/39) occurred within 24 months of persistence with a cut-off represented by 18 months (p = 0.001) in which the relapse rate is maximum and the most frequently found genotype was the 16th with 31 (79.5%) cases of recurrence. Kruskal-Wallis test with Dunn's multiple comparisons has shown statistically significant difference in the time of development of CIN2 relapses among HPV16 and other genotypes. (p < 0.05). Kaplan-meier analysis has shown statistically significant difference between the time to CIN2+ relapse onset in patients with HPV 16 infection and patients with other hrHPV genotypes. (p < 0.05) Conclusions: the study results suggest that persistent HPV infection after LEEP with the same HR genotype present before surgery represents one of the most important predictive factors of the risk of CIN2+ recurrence. The persistence of HPV16 for the first 18 months strongly correlates with the risk of developing a CIN2+ recurrence.

Keywords: CIN2+; HPV persistence; LEEP; follow-up; recurrence; relapse.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow-Chart of study population.
Figure 2
Figure 2
The time of development of CIN2 relapses among HPV16 and others genotypes. (Kruskal-Wallis test with Dunn’s multiple comparisons).
Figure 3
Figure 3
Kaplan-Meier analysis. The time to CIN2+ relapse insurgence in patients with HPV 16 infection and patients with other hrHPV genotypes.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Centers for Disease Control and Prevention How Many Cancers Are Linked with HPV Each Year? [(accessed on 5 January 2023)];2014 Available online: http://www.cdc.gov/cancer/hpv/statistics/cases.htm.
    1. Bosch F.X., de Sanjosé S. Chapter 1: Human papillomavirus and cervical cancer burden and assessment of causality. J. Natl. Cancer Inst. Monogr. 2003;31:3–13. doi: 10.1093/oxfordjournals.jncimonographs.a003479. - DOI - PubMed
    1. Reich O., Regauer S. Elimination of reserve cells for prevention of HPV-associated cervical cancer. Virus Res. 2023;329:199068. doi: 10.1016/j.virusres.2023.199068. - DOI - PMC - PubMed
    1. Giuliano A.R., Nyitray A.G., Kreimer A.R., Pierce Campbell C.M., Goodman M.T., Sudenga S.L., Monsonego J., Franceschi S. EUROGIN 2014 roadmap: Differences in human papillomavirus infection natural history, transmission and human papillomavirus-related cancer incidence by gender and anatomic site of infection. Int. J. Cancer. 2015;136:2752–2760. doi: 10.1002/ijc.29082. - DOI - PMC - PubMed
    1. Hübbers C.U., Akgül B. HPV and cancer of the oral cavity. Virulence. 2015;6:244–248. doi: 10.1080/21505594.2014.999570. - DOI - PMC - PubMed

LinkOut - more resources