The negative conversion of high-risk human papillomavirus and its performance in surveillance of cervical cancer after treatment: a retrospective study

Arch Gynecol Obstet. 2017 Jan;295(1):197-203. doi: 10.1007/s00404-016-4197-4. Epub 2016 Sep 13.

Abstract

Purpose: To determine the negative conversion regularity of high-risk human papillomavirus (HR-HPV) and to evaluate the prognostic implications of HR-HPV testing in patients with cervical cancer after treatment.

Methods: A retrospective post-treatment analysis of 173 patients with cervical cancer was performed from January 2011 to December 2012. Patients who had HR-HPV infection before treatment were included. Clinical and pathological characteristics, as well as follow-up information, were reviewed.

Results: The negative conversion rate of HR-HPV reached 68.9 % within half a year and increased most rapidly within the first 2 years after treatment. Univariate and multivariate analyses suggested that the negative conversion rate of HR-HPV was significantly correlated with clinical stage, treatment regimens, and HR-HPV type (P < 0.05). In our analysis of 173 patients, we found that HR-HPV status was predictive of 3-year survival rate and disease recurrence (P < 0.05). Pelvic recurrence, but not distant metastasis, was influenced by HR-HPV status (P < 0.05). Through 2 × 2 table analysis, we found that HR-HPV was more sensitive (71.43 %) and specific (94.20 %) than cervical cytology (sensitivity 62.86 % and specificity 78.26 %).

Conclusions: The negative conversion rate of HR-HPV increased most rapidly within the first 2 years of cervical cancer surveillance. Persistent HPV infection was associated with a poor prognosis and had an impact on recurrence sites. Further large and multi-center prospective studies should be performed, but these results of this study suggested that HR-HPV monitoring is necessary to be used as a means of cervical cancer surveillance.

Keywords: Cervical cancer; High-risk human papillomavirus; Negative conversion; Prognosis.

MeSH terms

  • Adult
  • Aged
  • Female
  • Humans
  • Middle Aged
  • Neoplasm Recurrence, Local / complications
  • Papillomaviridae / isolation & purification*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / virology
  • Prognosis
  • Retrospective Studies
  • Sensitivity and Specificity
  • Uterine Cervical Neoplasms / pathology*
  • Vaginal Smears