The Utility of HPV Testing in Predicting Disease Recurrence Post Colposcopic Treatment for Cervical Intraepithelial Neoplasia.
Loretto Pilkington, Helen Keegan, Sharon O'Toole, Shoba Singh, Sinead Cleary, Walter Prendiville, Tom D'Arcy, Michael J Turner, Gunther VonBunau, Mary Anglim, John J O'Leary, Cara M Martin. Trinity College Dublin & The Coombe Women and Infants University Hospital, Dublin, Ireland; Coombe Women and Infants University Hospital, Dublin, Ireland; RCSI, Dublin, Ireland; University College Dublin, Ireland
Background: The risk of disease recurrence post treatment with LLETZ for high grade CIN ranges from 5-35%. Women with evidence of persistent HPV infection following treatment have a higher incidence of disease recurrence than those who clear their HPV post-treatment. The aim of this study is to evaluate the utility of HPV DNA and mRNA testing in the follow-up of women post treatment.
Design: To date, 800 women presenting for their first visit to the colposcopy clinics at the Coombe Women and Infants University Hospital have been prospectively enrolled in the study. Cervical cytology specimens are taken at first visit prior to colposcopic procedure and at regular intervals during follow up. High risk HPV DNA is detected using Hybrid Capture II assay (Qiagen) and HPV mRNA is detected using HPV PreTect Proofer (Norchip)
Results: 522/800 women recruited, have been treated by LLETZ/LOOP. The data presented in this abstract relates to 294 patients treated by LLETZ for low grade (n=53) and high-grade disease (n=241) on cytology/colposcopy. The prevalence of high risk HPV DNA and mRNA in these women prior to treatment was 94% and 85% respectively. HPV 16 was the most predominant HPV type representing 65% of the cohort. Histological examination revealed 83% had CIN2+ disease, 13 % CIN1, 1% cGIN and 3% Normal. Post colposcopic follow up of these women, at 6-12 months post treatment, indicated HPV DNA persistence in up to 20% of cases, of which 13% had abnormal cytology.
Conclusions: HPV DNA/mRNA testing is useful for predicting recurrence of CIN in women treated for high grade CIN and can be used as test of cure in the colposcopy setting.
This study is funded under the CERVIVA Programme by the Health Research Board, Ireland.
Category: Gynecologic & Obstetrics
Tuesday, March 1, 2011 9:30 AM
Poster Session III # 210, Tuesday Morning