The Clinical Efficacy of HPV DNA test by Hybrid Capture Assay after LEEP in Cervical Intraepithelial Neoplasia

Objective : This study was undertaken to analyze the relationship between the detection of HPV DNA and the recurrence of cervical intraepithelial neoplasia (CIN) after Loop Electrosurgical Excisional Procedure (LEEP).Thus We intended to evaluate the clinical effectiveness of HPV DNA test by Hybrid Capture Assay (HCA) as a predictor for the recurrence of CIN after LEEP.Methods : From May 1993 to Dec. 1999, 342 patients who were diagnosed as CIN and treated with LEEP in Department of Obstetrics and Gynecology at Ewha Womans University Mokdong Hospital were reviewed retrospectively.All patients received HPV DNA test only for high-risk group HPV by Hybrid Capture Assay (system I) just before LEEP and were followed up with Pap smears and HPV DNA tests at the interval of 3 months during the first year and then at the interval of 6 months after LEEP.The Chi-square test and Student t-test were used for the statistical analysis.Results : HPV DNA tests before LEEP were positive in 71.3% (244/342).Positivity of HPV DNA after LEEP was 10.9% (35/320) at 3 months, 9.8% (17/173) at 6 months, 7.3% (10/137) at 9 months, and 5.7% (6/105) at 12 months, 5.7% (4/70) at 18 months and 7.5% (3/40) at 24 months.A higher recurrence rate was noted in the HPV DNA positive group, comparing with the negative group, at 3 months (57.1% in positive vs 3.5% in negative; p<0.01), at 6 month (64.7% in positive vs 9.5% in negative; p<0.01) and at 9 months (70.0% in positive vs 13.3% in negative; p<0.01).But there was no more statistical significant difference in recurrence rates between positive group and negative group of HPV DNA tests after 12 months.Also, there were no significant associations between the recurrence of CIN and histopathologic factors such as positive resection margin, endocervical glandular involvements and histologic grades.Conclusion : HPV DNA test by HCA before and after LEEP may be considered as a useful and unique tool for the prediction of recurrence of CIN, especially within 1 year after LEEP.