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
Meta-Analysis
. 2024 Mar 14;19(3):e0298520.
doi: 10.1371/journal.pone.0298520. eCollection 2024.

The residual rate of HPV and the recurrence rate of CIN after LEEP with negative margins: A meta-analysis

Yong Lin  1 , Yan Long  1 , Jin He  1 , Qinqin Yi  1
Affiliations
Meta-Analysis

The residual rate of HPV and the recurrence rate of CIN after LEEP with negative margins: A meta-analysis

Yong Lin et al. PLoS One. .

Abstract

Background: HPV is detected in up to 47% of CIN and up to 70% of cervical cancers. It can cause intraepithelial neoplasia, which can eventually progress to invasive carcinoma. Almost all cervical cancers are caused by HPV. Therefore, it is especially important to treat high-risk HPV. For patients who have undergone LEEP surgery, this procedure can effectively treat CIN. However, it has not been studied in a meta-analysis whether HPV remains after the surgery and whether residual HPV increases the recurrence risk of CIN. To address this gap, our study collected all relevant literature to investigate the residual rate of HPV and its potential influence on the recurrence rate of CIN. We aim to provide valuable recommendations for clinicians and patients.

Methods: The Cochrane Library, EMBASE, and PubMed databases were searched from the establishment of the database until October 2023. Stata 12.0 software was used for the statistical analysis.

Results: Twelve studies were included, with a total sample size of 1192 cases. The meta-analysis found that the recurrence rate of CIN was quite low [95% CI = 0.5% (0.001, 0.012); P = 0.006] when the margins were negative after LEEP and there was no residual HPV. When HPV was present, the recurrence rate of CIN was significantly higher [95% CI = 18% (0.089, 0.291), P = 0.000], even if the margins were negative. The recurrence rate of CIN with residual HPV was 3.6 times higher than the recurrence rate of CIN without residual HPV. The residual rate of HPV after LEEP with negative margins was 22.7% [95% CI (0.167, 0.294), P = 0.000], which remained relatively high.

Conclusion: This meta-analysis found that the recurrence rate of CIN without residual HPV and with negative margins after LEEP was quite low, at 0.5%. However, when HPV was residual, the recurrence rate of CIN significantly increased to 18%, even if the margins were negative. The residual rate of HPV was 22.7%, even when the margins were negative after LEEP.

PubMed Disclaimer

Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. The process of literature screening.
Fig 2
Fig 2. Forest plot of the residual rate of HPV after LEEP with negative margins.
Fig 3
Fig 3. Forest plot of the recurrence rate of CIN with residual HPV and negative margins after LEEP.
Fig 4
Fig 4. Forest plot of the recurrence rate of CIN without residual HPV and with negative margins after LEEP.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Przybylski M, Pruski D, Wszołek K, de Mezer M, Żurawski J, Jach R, et al.. Prevalence of HPV and Assessing Type-Specific HPV Testing in Cervical High-Grade Squamous Intraepithelial Lesions in Poland. Pathogens. 2023. Feb 19;12(2):350. doi: 10.3390/pathogens12020350 - DOI - PMC - PubMed
    1. Winer RL, Hughes JP, Feng Q, O’Reilly S, Kiviat NB, Holmes KK, et al.. Condom use and the risk of genital human papillomavirus infection in young women[J]. N Engl J Med. 2006;354:2645–2654. - PubMed
    1. de Martel C, Ferlay J, Franceschi S, Vignat J, Bray F, Forman D, et al.. Global burden of cancers attributable to infections in 2008: a review and synthetic analysis[J]. Lancet Oncol. 2012;13:607–615. - PubMed
    1. Chaturvedi AK. Beyond cervical cancer: burden of other HPV-related cancers among men and women[J]. J Adolesc Health. 2010;46:S20–S26. - PubMed
    1. Tota JE, Chevarie-Davis M, Richardson LA, Devries M, Franco EL. Epidemiology and burden of HPV infection and related diseases: implications for prevention strategies[J]. Prev Med. 2011;(53 Suppl 1):S12–S21. - PubMed

Publication types

MeSH terms