Value of loop electrosurgical excision procedure and high-risk human papillomavirus testing for high-grade cervical intraepithelial neoplasia

Objectives To determine the value of loop electrosurgical excision procedure (LEEP) for the management of high-grade cervical intraepithelial neoplasia (CINⅡ-Ⅲ) and to evaluate whether high-risk human papillomavirus (HR-HPV) infection is associated with the prognosis of the patients who underwent LEEP for high-grade CIN.Methods The study was conducted on 112 patients who underwent cervical biopsy by colposcopy and LEEP for high-grade CIN, and HR-HPV testing was performed by PCR at the time of conization.Results Of 112 patients who underwent LEEP, 67 were CIN Ⅱ and 45 were CIN Ⅲ (including CIS). The overall cure rate was 87.5%.Fourteen residual lesions (12.5%) and 4 recurrences (3.6%) were observed. Of these patients, 92 ((82.1%)) were positive for HR-HPV testing. The positive rate in CIN Ⅲ (93.3%) was significantly higher than that in CIN Ⅱ (74.6%,P0.05).Any statistically significant difference in residual disease or recurrence between the two groups was not observed: HR-HPV positive or negative rate was 10.9% vs 20.0%, or 4.3% vs 0((P0.05)).Of the 13 patients who underwent the second LEEP for residual disease or recurrence, 12((92.3%))also had persistent HR-HPV infection.Conclusions LEEP is a kind of effective and safe method for the diagnosis and treatment of high-grade CIN. HR-HPV may play an important role in the occurrence of high-grade CIN. Pretreatment HR-HPV testing seems to have no predictive value for the prognosis of the patients who undergo LEEP for high-grade CIN. Posttreatment HR-HPV testing may be useful in the follow-up of patients after conization. Loopelec