Value of Human Papilloma Virus load in hybrid capture II assay to predict high grade cervical intraepithelial neoplasia in menopausal women with ASCUS or LSIL / 대한산부인과학회지

OBJECTIVE: To evaluate whether determination of the Human Papilloma Virus (HPV) viral load is helpful to predict the presence of high-grade cervical intraepithelial neoplasia (CIN) that requires aggressive treatment in menopausal women who have presented with an unsatisfactory colposcopic finding and ASCUS or LSIL. METHODS: In menopausal women with ASCUS or LSIL and with who were positive for HPV, 54 women had diagnostic conization were analyzed retrospectively. We used the Hybrid Capture II method. We classified women in a low-risk group (chronic cervicitis, CIN I) and a high-risk group (> or =CIN II) according to the pathological results of conization. We also classified patients into the HPV viral load or =100 RLU/PC group. We analyzed the relationship between the pathological results of conization and viral load. RESULTS: For the conization, 30 women had chronic cervicitis, nine women had CIN I, three women had CIN II and 12 women had CIN III. In the low Hybrid Capture titer-group ( or =CIN II pathology but in the high Hybrid Capture titer-group (> or =100 RLU/PC), 11 women had high risk pathology this finding was statistically significant (P=0.013). Compared to the low Hybrid Capture titer group, the relative risk of high grade CIN (> or =CIN II) in the high Hybrid Capture titer group was 2.043 (95% CI, 1.216~3.432). CONCLUSIONS: For menopausal women with an unsatisfactory colposcopic finding and also have ASCUS or LSIL women with high HPV viral load might have tendency of > or =CIN II pathology.

Significance of HPV viral load for prediction of recurrence after treatment in patients with carcinoma in situ of cervix / 부인종양

OBJECTIVE: The purpose of this study is to verify association between HPV viral load and recurrence after conization and analyse clinicopathological characteristics in patients with carcinoma in situ of cervix. METHODS: We reviewed the chart of 154 women with carcinoma in situ who underwent conization from January 2003 to December 2005. Pap smear and high risk HPV test was performed before treatment and colposcopic examniation with biopsy was performed in necessary. After operation, repeated Pap smear and quantitative high risk HPV test (Hybrid capture II test, HC II) were performed in three month after conization for recurrence of disease. We studied the medical records of the patients, analyzed demographic characteristics and conducted the correlation between the prognostic factors of the age, parity, presence of high risk HPV infection before and after the operation, existence of invasion of resection margin after conization and remaining or recurrent lesions. RESULTS: Positive of cone margin showed significantly high recurrence rate than negative cone margin (p<0.05). And posttreatment HPV viral load was significantly higher in recurrent patients (p<0.05). But initial Pap smear, age and parity has not shown in difference. CONCLUSION: We can conclude that a clear association between positive cone margin, high HPV viral load and recurrence of disease after conization. A patient with positive resection margin after or high viral load after conization should be evaluated and treated aggressively.