Cervical Conisation for High Grade Dysplasia (CIN III) in 38 HPV Vaccinated Women
Ondrej Ondic, Jana Kaspirkova. Biopticka Laborator, Plzen, Czech Republic; Charles University Prague, Plzen Medical Faculty, Plzen, Czech Republic
Background: To the best of our knowledge fenomenom of high grade dysplasia in HPV vaccinated women has not been systematically investigated so far. The biggest prospective multicentric study PATRICIA studying more than 9000 vaccinated young women yielded only 3 cases. We present single institution experience describing 38 cases of high grade dysplasia in cervical cone-biopsy of HPV vaccinated women.
Design: Cross-reference of laboratory's database for the words "HPV vaccination" and "conisation" yielded 38 patients. Histology slides were reviewed and tested for HPV infection using a set of 3 different PCR methods and ISH. All available PAP-smear results of each patient were analyzed. They were not available in 6 cases.
Results: 8 (21%) women were of the age 16 to 20 years when vaccinated. Only 1 woman was less than 18 years old. 25 (78%) women had abnormal PAP-smears before the vaccination was finished. Of those 36% had abnormal PAP-smears only in the year of vaccination. Only 1 (3%) woman had negative PAP-smears prior to vaccination (proved negative even after review). Spectrum and distribution of HPV types detected in conisation tissue did not differ from normal Czech population, except for higher rate of HPV type 35. In the subgroup of women younger than 20 years HPV types 31, 51, 52 were detected more often than expected.
Conclusions: High grade dysplasia of cervix appears mostly (78%) in women with abnormal PAP-smears prior to vaccination. 97% of cases developed in women over 18 years of age at the time of vaccination. There was a statistically significant increase of high grade dysplasia associated with HPV 35. In the subgroup of women younger than 20 years there was ascending trend of cases associated with HPV 31, 51, 52. We propose establishment of National Dysplasia After Vaccination registry to monitor this fenomenon.
Category: Gynecologic & Obstetrics
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 222, Tuesday Afternoon