子宫颈上皮内瘤变的高危型HPV负荷量对治疗后复发的影响

目的 探讨术前子宫颈上皮内瘤变(CIN)的高危型人乳头瘤病毒(HR-HPV)的负荷量与CIN治疗后复发的关系.方法 选择205例CIN患者,术前均采用第二代杂交捕获法(hybrid captureⅡ,HC-Ⅱ)检测HPV负荷量,术后6-8月于阴道镜下行子宫颈活检病理检查.结果 术前HR-HPV负荷量与CIN呈等级正相关(r=0.4288,P＜0.01),经6-8月随访,发现25例CIN复发,其术前HR-HPV负荷量均＞1 000 RLU/CO,术后CIN复发与术前HR-HPV负荷高负荷量有关(P＜0.01),与术前CIN级别无关(P＜0.01).结论 C1N术前HR-HPV高负荷量(＞1 000 RLU/CO)可增加术后CIN复发的危险性.     

高载量HR—HPV感染与宫颈癌及其癌前病变关系的研究

目的 研究宫颈病变中HR—HPV病毒载量的分布,探讨高载量HR—HPV感染与宫颈癌及其癌前病变发生发展的关系。方法对门诊就诊的3676名妇女进行HC-Ⅱ HPV DNA检测,按HPV病毒载量的不同分为4组：阴性组RLU／CO〈1．0,低载量组1．0≤RLU／CO〈10,中载量组10≤RLU／CO〈100,高载量组RLU／CO≥100,采用非条件多项式logistic回归分析病毒载量与子宫颈各级病变的关系。结果CINⅠ组高载量占23．07％,其OR值仅为9．42（95％CI：6．84—12．99）;CINⅡ组高载量占30．84％,其OR值为22．55（95％CI：14．88—34．18）;CINⅢ组高载量占47．89％,其OR值高达82．13（95％CI：52．69—128．03）;宫颈癌组51．66％呈高病毒载量,其OR值更高达161．90（95％CI：109．45—239．50）。,结论HPV病毒载量与宫颈病变的严重程度密切相关,高载量HR—HPV持续感染预示着宫颈高度病变及宫颈癌     

女性宫颈高危型HPV感染状况及其与宫颈病变剂量—效应关系分析

目的 探讨女性宫颈高危型人乳头瘤病毒(hrHPV)感染现状并分析hrHPV病毒载量与宫颈病变之间剂量—效应关系。方法 对26294份宫颈细胞学送检标本采用杂交捕获第二代方法(HC-Ⅱ)检测HPV-DNA含量,病毒载量以相对光单位(RLU)与界值点(Cutoff)比值衡量。以RLU/CO≥1.0为阳性。宫颈病变按组织学活检以CIN2及以上级别病变为病例。假设检验采用χ²检验;用Mantel趋势分析分析剂量—效应关系。结果 26294例受检对象总体阳性检出率为26.74%,年龄分布在15~84岁之间,平均年龄为（33.54±8.43）岁。hrHPV病毒载量与宫颈病变存在剂量—效应关系(χ_trend=8.000,P<0.001)。结论 广东省女性hrHPV感染阳性检出率较高;hrHPV病毒载量与宫颈病变之间存在剂量—效应关系。     

高危型人乳头状瘤病毒的病毒负荷量与宫颈癌及宫颈上皮内瘤变的关系

目的探讨高危型人乳头状瘤病毒(HPV)的病毒负荷量与宫颈癌及宫颈上皮内瘤变(CIN)的相关性。方法选取2013年6月至2016年6月间北京市健宫医院收治的1056例行宫颈癌筛查的患者,对高危型HPV的脱氧核糖核酸(DNA)行第2代杂交捕获试验(HC-Ⅱ)半定量检测,予以受试者工作特征曲线(ROC曲线)分析,对CINⅡ及以上宫颈病变理想RLU/CO界值进行判定。结果慢性宫颈炎592例(56.1%);CIN395例(37.4%),CINI级110例(10.4%),CINⅡ~Ⅲ级285例(27.0%);宫颈癌69例(6.5%)。高危型HPV病毒负荷量随着宫颈病变程度的加深而增高,差异有统计学意义(P<0.05)。慢性宫颈炎、CINI级、CINⅡ~Ⅲ级及宫颈癌患者高危HPV-DNA病毒负荷量中位数分别为33.24、58.37、103.48和172.56。ROC曲线分析,预测CINⅡ级及以上宫颈病变的最佳RLU/CO值为3.173,其灵敏度和特异度分别为89.0%和58.0%,Youden指数为0.587。结论高危型HPV病毒负荷量与宫颈癌及前期病变有着显著的相关性,会随着病情严重程度的加深而增加,预测CINⅡ及以上宫颈病变高危HPV最佳负荷量值为3.173。     

高危型 HPV 载量与分型检测对宫颈高级别病变预测价值的前瞻性队列研究*

目的:评价高危型人乳头瘤病毒（highriskhumanpapillomavirus,hrHPV ）载量和分型检测在中国农村地区妇女人群中预测宫颈鳞状上皮高级别病变发生的价值。方法:2012年5 月至2015年5 月以农村妇女人群为基础选取江西省兴国县、靖安县和玉山县2 257 例,年龄35～64岁纳入本前瞻性队列研究。同时采用HC- 2（hybridcapture-2）和导流杂交技术（HybriMax ）两种方法分别检测hrHPV 载量和亚型,两种方法中任一亚型阳性者行阴道镜及活检检查,并将HC- 2 检测阳性结果中病毒载量< 10.0 RLU/CO认定为低病毒载量,病毒载量≥ 10.0 RLU/CO为高病毒载量。对hrHPV 结果阴性或病理诊断为CIN 1 的2 211 例妇女行24个月无干预随访。根据随访分别评价hrHPV 载量和HybriMax 分型两种检测方法预测宫颈鳞状上皮高级别病变（CINgrade2 orworse,CIN 2 +）的效果。结果:纳入基线、随访数据完整的女性共1 636 例。2 年内采用HC- 2 检测的132 例基线高病毒载量妇女中CIN 2 +的发生率为3.03%（4/ 132）,其相对危险度（RR）值为42.24（95%CI 为4.76～375.2）;采用HybriMax 分型检测的159 例基线分型HPV 16或18型阳性妇女中CIN 2 + 的发生率为2.51%（4/ 159）,RR值为33.06（95%CI 为3.72～293.9）。 对2 年内HC- 2 检测中高病毒载量例数和HybriMax 分型检测中HPV 16/ 18型别阳性例数进行比较,CIN 2 + 的发病率差异无统计学意义（P > 0.05）。 结论:HPV高载量和HPV 16/ 18型别阳性妇女人群进展为CIN 2 + 的风险均较高。在不具有持续监测hrHPV 条件的农村地区,HC- 2 检测的病毒载量≥ 10.0 RLU/CO阈值设定,与HybriMax 分型检测HPV 16/ 18型别均对hrHPV 初筛有分流作用,并对CIN 2+ 发生有预测作用。      

人乳头状瘤病毒感染及病毒载量与宫颈病变的相关性研究

目的：研究高危型人乳头状瘤病毒感染及病毒载量与宫颈病变的关系。方法：对774例研究对象采用第二代杂交捕获试验（HC—Ⅱ）进行宫颈脱落细胞的HPV-DNA定量检测。分析不同程度宫颈病变的HPV感染情况,并根据HPV病毒载量将所有检测对象分为四组,阴性（RLU／CO〈1．0）、低载量（1．0≤RLU／CO〈10）、中载量（10≤RLU／CO〈100）、高载量（RLU／CO≥100）,采用非条件多项式logistic回归分析病毒载量与宫颈病变级别的关系。结果：在检测的774例研究对象中,对照组、宫颈上皮内瘤变（cervical intraepithelial neoplasia,CIN）Ⅰ、CINⅡ、CINⅢ和浸润性宫颈癌患者的HPV感染率分别为21．29％、82．35％、80．00％、90．16％和86．67％。对照组高危型HPV感染率明显低于CIN和浸润性宫颈癌患者,差异有统计学意义,P〈0．01;HPV阳性者患CIN的风险是阴性者的24．96倍（95％CI：13．20～47．18）,患浸润性宫颈癌的风险是HPV阴性者的24．03倍（95％CI：12．01～48．09）。在不同级别宫颈病变中,CINI组的低病毒载量患者占11．67％,高载量占41．18％,OR值为23．84（95％CI：5．96～95．33）,P〈0．001;而在CINⅢ组中62．30％的患者呈高病毒载量,OR值达64．70（95％CI：25．98～161．20）,P〈0．001。结论：高危型HPV感染与CIN和浸润性宫颈癌的发生密切相关;宫颈高危型HPV病毒载量是影响宫颈病变严重程度的危险因素。     

宫颈上皮内瘤变相关影响因素病例对照研究

目的 宫颈癌是全球范围内高发于女性的恶性肿瘤,宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)是其癌前病变.本研究旨在探讨CIN的相关影响因素,分析高危型人乳头瘤病毒(high-risk human papillomavirus,HR-HPV)及沙眼衣原体(chlamydia trachomatis,CT)感染与CIN的相关性.方法 选择2010-01-01-2014-04-30柳州市人民医院门诊就诊的女性患者,共纳入符合筛查条件的患者12 644例,行宫颈脱落细胞CT和HR-HPV-PCR检测,以及液基薄层细胞学检查,必要时宫颈活组织检查.记录CT及HR-HPV不同感染状态发生CIN的情况,应用SPSS17.0软件包进行非参数检验和多因素Logistic回归分析.结果 12 644例患者中,检查出CIN 260例,检出率为2.06％.HR-HPV(OR=18.516)、CT感染(OR=2.602)、妊娠次数增加(OR=1.477)和年龄(OR=1.690)与CIN发生相对危险度增加.以HR-HPV和CT不同感染状态进行分层,CIN在不同HR-HPV及CT感染状态组别中发生率不同,HR-HPV和CT均阳性组最高(18.00％),其次依次为HR-HPV阳性组(10.26％)、CT阳性组(1.97％)、HR-HPV和CT均阴性组(0.49％),差异均有统计学意义,x2 =875.927,P＜0.001.结论 年龄与孕次增加是CIN发生的相关影响因素,HR-HPV与CIN发生密切相关,宫颈CT感染亦与CIN发生相关,CT与HR-HPV协同可能增加CIN发生.     

子宫颈环型电切术治疗子宫颈上皮内

摘 要：［目的］ 分析子宫颈环型电切术（LEEP）治疗子宫颈上皮内瘤变（CIN）的疗效及其影响因素、术后随访时机,为LEEP规范化治疗CIN提供科学依据。［方法］ 选择2009年6月至2010年12月在深圳市妇幼保健院因CIN行LEEP治疗病例1535例作为研究对象,并在术后随访2年,观察LEEP治疗效果。［结果］ 1535例患者中排除确诊为浸润癌的13例患者,随访2年时间共1297例,随访率为85.2%（1297/1522）,其中持续存在或复发35例（含浸润癌1例）,病变持续存在或复发率2.7%;治愈1262例,治愈率97.3%。术后切缘阳性组病变持续存在或复发率明显高于阴性组（P＜0.01）。术前HPV16/18亚型感染患者LEEP治疗失败风险是其他亚型感染患者的3.383倍。术后第6个月HR-HPV载量≥1.0×105 copies/ml的患者病变持续存在或复发率明显高于< 1.0×105 copies/ml者（OR=23.851,P＜0.01）。术后第6个月HR-HPV阳性率和细胞学检查阳性率明显下降,较术后第3个月明显降低 (P<0.05),与术后6个月后的HR-HPV阳性率和细胞学检查阳性率无统计学差异(P>0.05)。［结论］ LEEP治疗CIN的治愈率较高,并发症的发生率相对较低;切缘阳性、HPV16/18亚型感染、术后第6个月HR-HPV载量≥1.0×105 copies/ml是本组研究对象LEEP治疗后子宫颈上皮内瘤变持续存在或复发的影响因素;LEEP治疗后6个月是评价疗效的起始时间。     

子宫颈锥切术后切缘阳性的高级别CIN患者病灶残余的相关因素研究

[目的]探讨子宫颈锥切术后切缘阳性的高级别子宫颈上皮内瘤变(CIN)患者病灶残余的相关因素,为其进一步诊疗提供依据。[方法]收集初次子宫颈锥切术切缘阳性并行二次手术的64例高级别CIN患者的临床资料,并对其病灶残留及相关因素进行分析。[结果]二次手术患者术后病理提示CIN共25例,其病灶残留率为39.1%。年龄≤35岁者病灶残留率为19.0%,年龄>35岁者为48.8%,差异有统计学意义(P<0.05)。术前子宫颈脱落细胞(LBC)检测提示高度上皮内病变组病灶残留率(52.5%)明显高于低度上皮内病变组(16.7%),差异有统计学意义(P<0.01)。术前高危型HPV DNA>300RLU/CO时病灶残留率明显高于≤300RLU/CO,两者差异亦具有统计学意义(P<0.05)。多因素Logistic回归分析发现,年龄>35岁、LBC提示高度上皮内病变是与初次锥切切缘阳性病灶残留高度相关的因素,其危险度分别为3.872、3.025。[结论]患者年龄和LBC结果与初次手术病灶残留有相关性,对于此类患者应予以高度重视。     

维吾尔族妇女宫颈癌发生与EBV及HPV感染的关系

目的:探讨维吾尔族妇女宫颈癌发生过程中EB病毒(Ebstein-Barr virus,EBV)及人乳头瘤病毒(human papillomavirus,HPV)感染的作用及其意义。方法:收集维吾尔族妇女宫颈炎、宫颈内上皮瘤样病变(cervical intraepithelial neoplasja,CIN)Ⅰ/Ⅱ/Ⅲ和宫颈鳞癌患者福尔马林浸泡与石蜡包埋组织标本共178例,提取DNA并采用PCR方法对EBV和HPV DNA进行检测;用免疫组织化学方法检测宫颈癌EBV蛋白表达。结果:病毒DNA检测结果显示,宫颈炎、CINⅠ、CINⅡ～Ⅲ和宫颈癌患者各组HPVDNA检出率依次足2.5%、12.5%、68.0%、96.4%,EBV DNA为0、3.1%、28.0%和69.6%,其中宫颈炎组与CINⅡ～Ⅲ和宫颈癌组问的差异具有统计学意义(P均0.05),但宫颈炎与CINI组间的差异无统计学意义(P0.05)。宫颈病变病理进程不仅伴随着HPV及EBVDNA阳性检出率梯度上升,而且与HPV和EBV双重感染检出率增高呈正相关(r=0.46,X~2=82.50,P0.001)。对宫颈癌组织进行免疫组织化学分析,发现EBV DNA检测阳性标本中EBV蛋白阳性表达检出率为89.7%(34/39),而阴性标本中蛋白表达阳性率为6%(1/17)。结论:维吾尔族妇女宫颈癌的发生与发展可能与HPV和EBV双重感染密切相关。     

Pap Smear Combined with HPV Testing: A Reasonable Tool for Women with High-grade Cervical Intraepithelial Neoplasia Treated by LEEP

Background: To evaluate HPV testing by Hybrid Capture II (HCII) in conjunction with cytology in detectingthe residual/recurrence disease after treatment of high-grade cervical intraepithelial neoplasia (CIN II-III) withloop electrosurgical excision procedure (LEEP). Materials and Methods: A retrospective review of 158 patientswith histologically confirmed CIN II-III who underwent LEEP between January 2011 and October 2012 wasconducted. Post-treatment control was scheduled at the 3rd, 6th, 12th and 18th month. All patients were followedup by Pap smear and HR-HPV genotype and viral load testing. Results: Pre-treatment, HR-HPV DNA, wasdetected in all specimens of the patients. At follow-up, 25 patients were diagnosed as the residual/recurrent diseaseduring the FU visit, among whom, 16 patients with positive margin: 13 patients (52%) with HR-HPV DNA+/cytology+, 2 patients (8%) with HR-HPV DNA+/cytology-, 1 patient (4%) with cytology+/ HR-HPV DNA-; 9patients with clean margin – 5 patients (55.6%) with HR-HPV DNA+/cytology+; 2 patients (22.2%) with HRHPVDNA+/cytology-, 2 patients (22.2%) with cytology+/ HR-HPV DNA-. None of them persisting HR-HPVDNA-/cytology- with positive or negative margin was identified as the residual/recurrent disease. The majorityof residual/recurrent disease was detected at the 12th and 18th month FU, and there was almost no differencein the sensitivity and negative predictive value (NPV) between at the 3rd month and the 6th month FU visits. 14residual/recurrence disease (14/46:30.4%) had pre-treatment high viral load (>5 000 RUL/PC) and 11 (11/112,9.8%) with pre-treatment low viral load, P<0.05. Conclusions: (1) The persistence HR-HPV DNA is the rootcause of the residual/recurrent disease for the women treated for high-grade CIN; the pre-treatment viral loadand margin can be seen as the predictor. (2) The FU visit beginning at the 6th month post-treatment and lastingat least 24 months with the combination of cytology and HPV testing. (3) Patients with high pre-treatment HPVload, which is considered as one risk of developing the residual/recurrent disease, should be paid more attention(especially above 500RUL/PC) to by clinicians.     

Persistence and load of high-risk HPV are predictors for development of high-grade cervical lesions: a longitudinal French cohort study

Oncogenic HPV types are the major cause of worldwide cervical cancer, but only a small proportion of infected women will develop high-grade cervical intraepithelial neoplasia or cancer (CIN2/3+). We performed a prospective study including 781 women with normal, atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LGSIL) cytology, and infected or not by high-risk (HR) HPV tested by Hybrid Capture II. Women were followed up every 6 months for a median period of 22 months. Among the HR-HPV-positive women at entry, more than half cleared their virus in 7.5 months; the clearance rate was greater for low viral loads than for high loads and also was higher in women with an initial ASCUS/LGSIL smear than in women with normal cytology. The incidence of cytologic abnormalities strongly depended on baseline viral load and HR-HPV persistence. Maintenance of cytologic abnormalities was associated with the outcome of HR-HPV status (negative or =100 pg/mL). Conversely, women who were consistently HR-HPV negative or transiently HR-HPV positive, whatever the cytology at baseline was, did not develop CIN2/3+ during follow-up. Age seemed to affect only the rate of incident HR-HPV infection. In conclusion, our data suggest that women repeatedly tested positive for HR-HPV are at risk of developing CIN2/3+, even when initial cytology is normal. A high viral load could be used as a short-term marker of progression toward precancerous lesions, although lower load does not inevitably exclude progressive disease.     

High load for most high risk human papillomavirus genotypes is associated with prevalent cervical cancer precursors but only HPV16 load predicts the development of incident disease

Cervicovaginal human papillomavirus (HPV) viral load has been purported as a potential marker for the detection of high-grade cervical intraepithelial neoplasia or cancer (>/=CIN2). To examine disease association with type-specific viral load for the full-range of anogenital HPV infections, we conducted cross-sectional and prospective analyses of approximately 2,000 HPV-infected women from a 10,000-woman population-based study in Guanacaste, Costa Rica with 7 years of follow-up. Cervical specimens were tested for >40 HPV types using a MY09/MY11 L1 consensus primer PCR method with type-specific dot blot hybridization and PCR signal intensity as a measure of viral load. A positive association was observed between prevalent >/=CIN2 and high viral load compared to low viral load for women with baseline single HPV16 infections (OR = 19.2, 95% CI = 4.4-83.2) and single non-16 carcinogenic infections (OR = 9.2, 95% CI = 2.1-39.9). Inclusion of women with multiple HPV types did not substantially change these associations. In prospective follow-up, only women infected with HPV16 alone (OR = 27.2, 95% = 3.5-213.5) had a strong association between high viral load and incident >/=CIN2; non-16 carcinogenic high viral load was not associated with incident >/=CIN2 (OR = 0.7, 95% CI = 0.2-1.9). Single noncarcinogenic type viral load was not associated with increased risk of prevalent or incident >/=CIN2 (OR = 1.2 and 1.1, respectively). In conclusion, carcinogenic high viral load was associated with prevalent >/=CIN2; however HPV16 was uniquely associated with incident >/=CIN2. The extent to which these observations can be translated into clinical practice must be rigorously examined in the context of the method of viral load measurement and the type-specific differences observed for incident >/=CIN2.     

Risk of high‐grade precancerous lesions and invasive cancers in high‐risk HPV‐positive women with normal cervix or CIN 1 at baseline—A population‐based cohort study

Infection with high‐risk human papillomavirus (HR‐HPV) is transient and clears on its own in majority of the women. Only a few women who have persistent infection may finally develop cervical intraepithelial neoplasia (CIN) or cervical cancer in later years. The risk of progression in the HR‐HPV‐positive women with normal cervix or low‐grade lesion on colposcopy and histopathology at baseline is less studied. We performed a longitudinal study on 650 HR‐HPV‐positive women with colposcopy and/or histopathology‐proved normal or CIN1 diagnosis at baseline to assess the cumulative risk of development of high‐grade CIN. After a mean follow‐up of 2.1 person years of observation (PYO) (range 0.1–5.1), the cumulative incidence of CIN2+ (6.4%; 3.0/100 PYO) was significantly higher in women who had persistent HR‐HPV infection compared to those who cleared the infection (adjusted HR 6.28; 95% CI 2.87–13.73). The risk of viral persistence in women aged 50–60 years was two times higher compared to women aged 40–49 years and three times higher compared to women aged 30–39 years. The probability of having persistent infection increased progressively with higher viral load at baseline (adjusted HR 3.29, 95% CI 2.21–4.90 for RLU ≥100; adjusted HR 2.69, 95% CI 1.71–4.22 for RLU 10–100). Women with increasing viral load at follow‐up had four times higher risk of developing CIN2 or worse lesions as compared to those with decreasing load (20.9% vs 4.8%; p < 0.001). In the context of developing countries where cytology or genotyping triaging is not feasible, colposcopy referral of HR‐HPV‐positive women with advancing age, viral persistence, and increasing viral load may be considered.     

高危型HPV负荷量与宫颈病变及术后随访的相关研究

[目的]探讨高危型HPV负荷量与宫颈病变及术后病毒持续感染的关系。[方法]对2008年1月至2012年11月体检发现的高危型HPV阳性且行宫颈LEEP术的749例患者临床资料及随访结果进行分析,观察高危型HPV负荷量与宫颈病变及术后病毒持续感染的关系。[结果]高危型HPV负荷量越大,宫颈病变级别越高。术后3个月高危型HPV阳性率约27．9％;术后6个月约8-3％;术后9个月约4．0％。宫颈LEEP术后3、6个月患者高危型HPV阳性表达率下降显著（术后3个月vs术前：χ2=-844．38,P=0．0001;术后6个月vs术后3个月：χ2=97．35,P=0．0001）;术后9个月高危型HPV阳性表达率较术后6个月下降,但无显著性差异。术前高危型HPV负荷量〈100RLU,CO、100～1000RLU,CO及〉1000RLU／CO三组术后6个月复查HPV阳性率分别为5.3％、9.4％及12．9％（P〈0．05）。[结论]高危型HPV负荷量与宫颈病变严重程度及持续感染存在明显相关性,针对高负荷量者需严密诊治及随访。     

A human papillomavirus (HPV)-16 or HPV-18 genotype is a reliable predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure for cervical intraepithelial neoplasia 3

Objective

This study was conducted using the human papillomavirus (HPV) DNA chip test (HDC), in order to determine whether the HPV genotype is a predictor of residual disease in a subsequent hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3.

Methods

Between January 2002 and February 2015, a total of 189 patients who underwent a hysterectomy within 6 months of LEEP caused by CIN 3 were included in this study. We analyzed their epidemiological data, pathological parameters, high-risk HPV (HR-HPV) load as measured by the hybrid capture II assay, and HR-HPV genotype as measured by the HDC. A logistic regression model was used to analyze the relationship between covariates and the probability of residual disease in subsequent hysterectomy specimens.

Results

Of the 189 patients, 92 (48.7%) had residual disease in the hysterectomy specimen, CIN 2 in seven patients, CIN 3 in 79 patients, IA1 cancer in five patients, and IA2 cancer in one patient. Using multivariate analysis, the results were as follows: cone margin positivity (odds ratio [OR], 2.43; 95% CI, 1.18 to 5.29; p<0.05), HPV viral load ≥220 relative light unit (OR, 2.98; 95% CI, 1.38 to 6.43; p<0.01), positive endocervical cytology (OR, 8.97; 95% CI, 3.81 to 21.13; p<0.001), and HPV-16 or HPV-18 positivity (OR, 9.07; 95% CI, 3.86 to 21.30; p<0.001).

Conclusion

The HPV-16 or HPV-18 genotype is a reliable predictive factor of residual disease in a subsequent hysterectomy following a LEEP for CIN 3.