Hpv recurrence after leep 11, 2. 2016. Restricting the analysis to the 18 patients with available HPV data at the time of hysterectomy, the beneficial effect of nonvalent vaccination was 89%. Hosp. article info abstract Article history: Received 12 February 2013 Available online 26 April 2013 Keywords: High grade A negative LEEP after HSIL cytology requires diligent surveillance, as our results show that CIN2+ recurrence risk is similar to that after LEEP with CIN2+. 8 € [ 30 ]. 5 to 80 months after baseline. Vaccination with a quadrivalent HPV vaccine after LEEP treatment is still required to prevent the recurrence of CIN2–3 [8]. , 2019, Denmark 14 Cervical cancer is caused by Human Papilloma viruses (HPV) and is preceded by precursor stages: Cervical Intraepithelial Neoplasia (CIN). In consideration of the possibility of recurrence even 10 years after LEEP, postoperative follow-up should last 10 years or HPV can lay dormant for many years after you contract it, and you may never experience symptoms. 05) Conclusions: the study results suggest that persistent HPV infection after LEEP with the same HR genotype present before surgery represents one of the most important predictive factors of the risk of CIN2+ recurrence. Persistent insecure HPV infection is closely and systematically related to high-grade cervical Background The present study aimed to evaluate the long-term oncological and obstetric outcomes following the loop electrosurgical excision procedure (LEEP) in patients with cervical intraepithelial neoplasia (CIN) and investigate the risk factors for recurrence and preterm birth. 001) and not the surgical method [13]. 61; 95% confidence intervals, 1. has suggested a notable correlation between HPV persistence and an increased risk of CIN2+ recurrence disease after conization for up to 1 year (recurrence risk of 13. Conclusions HPV types covered by the nonavalent HPV vaccination would potentially cover 94. The value of age as a factor that favors HPV persistence after LEEP is a subject of Clearance after first infection with a given HPV type was defined as 3 consecutively negative visits for that type following the last positive visit (a minimum of 1. Our study highlights that the HPV status after LEEP and margin involvement are independent risk factors for recurrence in patients with CIN who undergo LEEP. Normal Pap test results: No abnormal cervical cells were found. A retrospective analysis was performed on 423 women who underwent LEEP for CIN2/3 at Cangzhou Central Hospital between 2016 and 2020. 988). One patient with CIN2 in LEEP specimen showed invasive cancer during follow-up one month later after LEEP. 10 While research has identified additional risk factors such as age, Baseline HPV testing was conducted before or at treatment for most studies (96%). This study aims to quantify the prevalence of high-grade disease at the time of the second follow-up colposcopy visit, in a practice setting that utilizes laser ablation in addition to LEEP. Cervical intraepithelial neoplasia (CIN) is a precancerous lesion of cervical cancer and can be divided into low-grade squamous intraepithelial lesions (LSILs) and high Pap test results show whether cervical cells are normal or abnormal. 2022;378:e070135. But a LEEP can get rid of the abnormal cells that form in response to an HPV infection so that they never become cervical cancer. Scopus (42) Before LEEP and at every visit after LEEP HPV DNA test was performed: Hazard ratio of risk of recurrence of CIN2‐3 in women not receiving the vaccine vs women receiving the vaccine: 2. Nevertheless, the overall risk of recurrence after surgical treatment for CIN 2+ is around 10–14%, with 6% and 16. Moreover, HPV vaccination after LEEP indeed showed a significant protective role in the prevention of high-grade squamous intraepithelial lesion (HSIL) recurrence, as patients without HPV vaccination had a higher recurrence rate (OR = No evidence shows difference between CKC and LEEP for recurrence rate (P = . Management of high We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence. CIN recurrence occurred at 1 and 2 years by sixteen (18/110) and twenty (22/110) percentage of cases respectively. 492, P = 0. 27 to 2. The removal of Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. Assessing the long-term role of vaccination against HPV after loop electrosurgical excision procedure (LEEP): a Propensity-Score matched comparison. Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on For the evaluation of women treated by LEEP, we considered the following outcomes after LEEP: HPV infection, persistent HPV infection Is vaccination with quadrivalent HPV vaccine after LEEP effective in preventing recurrence in The median HPV infection rates for patients with CIN after treatment were approximately 27. LEEP among HIV-positive women. Recurrence of CIN After undergoing LEEP at UKD, 4. Persistent high-risk human papillomavirus (HR-HPV) infection is a significant predictor for post-conization recurrence, making HPV testing alongside cytology essential in follow-up strategies. , the 5-year recurrence risk of CIN2+ after conization/LEEP was 16. The factors related to rate of residual lesion were age, menopausal status, and HPV infection. 7%) women developed histologically confirmed recurrence. This combined testing approach improves diagnostic accuracy and aids in clinical decision-making, contributing to better management of patients and reducing the risk of cervical cancer development. Kocken et al. Our study showed the quadrivalent prophylactic HPV vaccination The conclusion of a recent meta‐analysis was that hr‐HPV results were more accurate than margin status in predicting recurrence, with higher sensitivity (91% vs 56%) and Objectives: Excisional cervical procedures, such as a Cold Knife Cone (CKC) or a loop electrical excision procedure (LEEP), are standard treatments for moderate to severe infection rates at the first and second year after LEEP were significantly lower in the V-group than that in NV-group (P = 0. Cervical intraepithelial neoplasia (CIN) is a premalignant squamous lesion of the uterine cervix diagnosed by cervical biopsy and histologic examination []. A Pap test may also come back as unsatisfactory. A study on the correlation between the prognosis of HPV infection and lesion recurrence after cervical conization. Most previously published studies are limited by short duration of follow-up averaging just 2 years [9], despite the fact that the mean time to recurrence is 4 years [16] and Notably, our study found no significant difference in HPV negativity rates after either FUS or LEEP (74. HPV persistence was the only factor associated with year recurrence after both laser conization (p = 0. 96), and CIN 3, positive deep cervical margin and cold coagulation were also factors affecting high-risk HPV infection after LEEP (adjusted hazard ratios 1. This study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2–3) is effective in HPV persistence was the only factor associated with [5-]year recurrence after both laser conization (p = 0. D. Recurrence diagnosis was established after biopsy. 36% (8/22), respectively (P=0. Also effect of LEEP on the clearance of HPV infection was evaluated for CIN 1 lesions. • HPV vaccination after treatment significantly reduces the risk of developing recurrent CIN2–3 related to the vaccine HPV types. The high risk factors for HSIL recurrence within 24 months after LEEP in HSIL patients include: positive HPV, abnormal cytology, and positive endocervical positive margin. The See more Here, we aimed to compare the recurrence rate following laser conization and loop electrosurgical excision procedure (LEEP) in patients with high-grade cervical dysplasia (HSIL/CIN2+). This study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2–3) is effective in preventing recurrence of CIN2–3. 009). Therefore, patients with HPV type 16 should be carefully monitored after LEEP [10, 11, 13]. doi: 10. The direct economic savings after the provisional suppression of procedures included in the 6-month control assessment per patient with high-grade intraepithelial lesion was estimated to be 172. In conclusion, the integration of HPV E6/E7 mRNA testing with TCT shows promise for the diagnosis of residual/recurrence after LEEP in patients with CIN. HPV testing after loop electrosurgical resection predicted HSIL recurrence at 24 months with similar diagnostic accuracy to HPV testing at 6 months. 79% during the 3–6 months follow-up and 84. Recurrence rate 1-5 years after treatment was defined as a biopsy finding of CIN 3/AIS or retreatment (loop electrosurgical excision procedure [LEEP], laser, cone, hysterectomy). 3467, 95% CI Background: Prophylactic human papillomavirus (HPV) vaccines are highly effective in reducing premalignant lesions of the cervix. 15). 04–1. It is crucial for patients to understand the residual rate of HPV after LEEP and the recurrence rate of CIN. 335-6. , depth, thickness and maximum diameter), histology of the first LEEP specimen and ECC specimen, number and location of involved margin sections, cervical cytology results, high-risk HPV results, biopsy and ECC findings during follow-up, and histology from Patients with persistent HPV 16 infection after treatment had a significantly higher risk for recurrence after conization compared to patients with non-16 HPV types infection (odd squamous cells of undetermined significance, CIN = cervical intraepithelial neoplasia, CIS = carcinoma in situ, HPV = human papillomavirus, LEEP = loop Unfortunately, there is a relatively high incidence of recurrence after conization, especially in patients with high-risk human papillomavirus (HR-HPV) Our study shows that persistent HPV infection after conization or LEEP was not obviously correlated with marriage. 11 A retrospective study showed that postoperative hr‐HPV results had high sensitivity (88. persistent lesions are defined as those that worsen and are found again <6 months after LEEP. Information that was collected included patient characteristics, details regarding the initial LEEP specimens (e. , et al. The recent Bogani et al. The reasons for recurrence after complete excision may include multifocal lesions, inadequate specimens, and HPV DNA persistence [11, 13]. Methods: We retrospectively analyzed 183 patients (mean age, 39. Age-specific predictors of cervical dysplasia recurrence after primary conization: analysis of 3,212 women. This retrospective study included patients with We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence. The majority of patients with HPV infection were HPV negative before treatment, but 16,4% were still HPV 16 positive after treatment, indicating that conization do not necessarily clear HPV infection rapidly. Unsatisfactory Pap test results: The lab Involvement of both endo- and ectocervical margins, presence of comorbidities and positive high-risk HPV DNA during follow-up were all found to further increase the risk of recurrence [12,13]. 5 years without evidence of Conclusion. The median HPV infection rates for patients with CIN after treatment were approximately 27. Fisher’s and Negative co-testing 6 months after LEEP can be considered a reliable test of cure as 3-year follow-up results are consistent with neither HSIL or cancer. 5% regardless of the margin status, and more than half of the recurrences occurred within 2. Keywords. Secondly, an excisional procedure removes the dysplastic lesion but not necessarily the normal epithelium infected by HPV. Background: Cervical cancer is caused by Human Papilloma viruses (HPV) and is preceded by precursor stages: Cervical Intraepithelial Neoplasia (CIN). Although most HPV infections are transient and cleared in a couple of years after exposure, 10–20% of HPV infections are latent and persistent []. BMJ. LEEP: cervical conization was performed under local anesthesia using a super high-frequency electric knife. In high-resource settings, the recommendations for follow-up after LEEP are to conduct visits with HPV testing and/or cytology at 6- to 12-month intervals after treatment until negative results are obtained . CIN is mostly found in women in their reproductive age and treated with a Loop Electrosurgical Excision Procedure (LEEP). HPV infection, TCT, and glandular involvement were associated with HSIL recurrence. 41 Another study revealed that, in a high‐risk population undergoing cervical conization for high‐grade cervical lesions with The removal of HSILs via LEEP is an effective and safe treatment option, with low recurrence rates and high HPV clearance rates . has suggested a notable correlation between HPV persistence and an increased risk of CIN2+ recurrence Therefore, patients with HPV type 16 should be carefully monitored after LEEP [10, 11, 13]. Among women living with HIV, treatment of cervical intraepithelial neoplasia of grade 2 or higher (CIN2+) with the loop electrosurgical excision procedure (LEEP) is more likely to clear infection with high-risk, Background/purpose This study aims to investigate whether women with cervical dysplasia after LEEP have an increased risk of pregnancy/childbirth complications or recurrence of dysplasia in an upcoming pregnancy. 049 and P = 0. 8, 9 The status of conization margins is equally important; positive margins often necessitate more intensive monitoring. A French retrospective study with a five-year follow-up period [ 10 ] also pointed out that the persistence of HPV after cervical conization was directly associated with an increased risk of Methodology In 2010–2018 we performed 106 loop electrosurgical excision procedures (LEEP) in patients of reproductive age with histological confirmation of HSIL. Cox proportional hazards regression models with restricted cubic splines were used to evaluate linear and non-linear associations between immune-inflammatory indices and recurrence risk. Genes methylation profile was assessed by MSP-PCR technique in formalin-fixed, paraffin-embedded cone specimens. Results: Recurrent CIN2+ was found in 268 patients after LEEP (268/4369, recurrence rate, 6. J. Three-fourths (83/110) of the participants had histological confirmation as CIN2/3 after LEEP. Because most AIS lesions are caused by HPV 16/18 infection, prophylactic HPV vaccination is an important step toward prevention of AIS, potentially reducing the incidence of Some studies[28, 29] have shown that HR-HPV status after LEEP is a better predictor of lesion recurrence than cytology and colposcopy findings. 52% (37/54) and 36. doi: 10. Objective: To evaluate the risk factors of recurrent high-grade cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after loop electrosurgical excision procedure (LEEP). Methods: One hundred and thirty-eight women with cervical intraepithelial neoplasia (CIN) grade 2/3 lesion on biopsy were included in a prospective follow-up study in Belgium and Nicaragua. Patients were followed up at diffe Adenocarcinoma in situ (AIS) of the uterine cervix is caused by infection with high-risk human papillomavirus and is the recognized precursor of invasive adenocarcinoma of the cervix. After a median follow-up of 33 months (range: 1–94 months), persistent/recurrent lesions were found in 50 patients (approximately 10%). Methods Data from 240 women after LEEP were analysed retrospectively. These women have a lifelong HPV detection was preoperatively performed in all patients, and intraoperatively LEEP or CKC was conducted after regular implementation of endocervical curettage. Objectives To assess human papilloma viruses (HPV) DNA test for detection of recurrences in cervical intraepithelial neoplasia (CIN) patients after loop electrosurgical excision procedure (LEEP). Methods This retrospective cohort study included patients who underwent LEEP for CIN Five-year recurrence rate was 8. 8%), and that the Objective: To evaluate the risk factors of recurrent high-grade cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after loop electrosurgical excision procedure (LEEP). Cytology, high-risk (HR) HPV presence, persistent HR HPV infection HPV; LEEP; vaccination 1. The clinical Can a LEEP procedure get rid of HPV? No. We calculated the Odds Ratio (OR) of women with peristent HPV 16 infection and positive margin, to have a recurrence. There were 61 (20. Human papillomavirus (HPV) infection is a high-risk factor for cervical cancer. LEEP was as effective as CKC with regard to recurrence rate. have previously demonstrated that HPV testing after treatment for HSIL can help to risk-stratify the population for further screening. The goal of management is to prevent possible progression to cancer while avoiding overtreatment since lesions can spontaneously regress and treatment can have morbid effects. The 2-year recurrence-free survival was 83. 28. HPV can lay dormant for many years after you contract it, and you may never experience symptoms. Several investigators have analyzed the sensitivity and specificity of HPV DNA testing compared with follow-up cytology to more accurately detect residual/recurrent disease after treatment [ 27 , 28 ]. It is so common that most people who are sexually active will get it at some point and not realize The aim of this study was to illuminate risks factors of residual lesions, and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive margin who underwent cervical conization. About 23% of patients develop CIN2+ after LEEP treatment due to residual or recurrent lesions. 042; P<0. Cox regression analysis was used to evaluate the risk factors of recurrence. , depth, thickness and maximum diameter), histology of the first LEEP specimen and ECC specimen, number and location of involved margin sections, cervical cytology results, high-risk HPV results, biopsy and ECC findings during follow-up, and histology from the Those with a normal HPV test after LEEP have a very low risk of having further high-grade cell changes (cervical intraepithelial neoplasia grade 2 or 3) in the near future. We observed that laser conization was associated with a lower risk of positive surgical margins in comparison to LEEP. Background 20–25% of women with high-grade cervical intraepithelial neoplasias (HSIL) have residual lesions after conization. 5% in those treated with LEEP. Recurrence is defined as lesions that are found 6 months following Objective To investigate the predictors of residual disease in a hysterectomy following a loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 3. Little is known about the effect of HPV vaccines on women with CIN who already are HPV Before LEEP and at every visit after LEEP HPV DNA test was performed: Hazard ratio of risk of recurrence of CIN2‐3 in women not receiving the vaccine vs women receiving the vaccine: 2. After ablative treatment, recurrence rates of similar magnitudes have been reported, but data are more limited. 840; 95% confidence interval, 1. Neither the depth [OR 0. • HPV vaccination after treatment may be considered in preventing recurrence of CIN2–3. 05). 3%) and specificity (80% vs 68. Several factors including severity and size of the lesion, status of the margins and persistence of high-risk (HR) Human Papillomavirus (HPV) have been associated with an increased risk of CIN recurrence after treatment [3,4]. Recurrence is reported up to 17%. 7%, Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. 975 (0. Recurrence is defined as lesions that are found 6 months This is a nested case–control study involving 33 cases with CIN recurrence and 114 controls without recurrence, HIV infected and noninfected, treated with LEEP, between 1999 and 2004. 8% vs 33. 6,14,15 After CIN II or CIN III treatment, the majority of patients (82. 9%) patients developed recurrence. Margin involvement in conization specimens was a significant factor predicting residual/recurrent disease after LEEP. Citation 10 , Citation 11 A recent study found significant increases in NLR, MLR, PLR and systemic inflammation response index (SIRI) values in patients with persistent HPV Identification of factors associated with human papillomavirus (HPV) cervical histopathology or recurrence/relapse following loop electrosurgical excision procedure (LEEP) would allow for better management of the disease. Anal Cancer. Methods: A systematic literature search was performed for studies reporting the impact of HPV vaccination on We retrospectively selected 105 samples from 100 patients with histologic diagnosis of CIN II-III with cytology immediately after LEEP with a first control post-LEEP between 2 and 6 months after treatment that included HPV determination, a minimal follow-up period of 12 months and maximum of 24 months, and at least 2 colpocytologic controls reduce the risk of recurrence after CIN surgery, and to review and update the history, ecacy, eectiveness, and safety of HPV vaccines, with a focus on the current status of global implementation of HPV vaccines and the obsta-cles they face. 023). Bogani G, Raspagliesi F, Sopracordevole F, et al. The study aimed to access the molecular remission of HPV infection in patients after LEEP — conization who refused to be vaccinated against HPV. In our study, the rate of persistent infection from HPV 16, after LEEP, Purpose of investigation: The aim of the study was to evaluate the rate of human papillomavirus (HPV) infection clearance after loop electrosurgical excision (LEEP) procedure conization for To seek the high-risk factors of human papillomavirus (HPV) persistence and residual lesion or recurrence after loop electrosurgical excision procedure (LEEP) focus on the A study has shown that consistent condom use after LEEP significantly reduces HPV-positive rates and also appears to significantly reduce rates of CIN recurrence and biomarkers of HPV expression. Introduction. 9% (n = 11) had Women with HSIL typically undergo conization/LEEP to remove cervical lesions, but the risk of HSIL lesions returning after surgical treatment remains higher than in the SPERANZA (SPERimentazione ANti HPV Zona Apuana) is a prospective clinical project designed to evaluate the clinical effectiveness of HPV vaccination after surgical STI Treatment Guidelines from CDC. The lack of differences in gene expression between LEEP-excised tissues with subsequent recurrence/relapse and LEEP-excised tissues without subsequent recurrence/relapse despite LEEP with clear margin suggests that added factors, apart from possible remains of dysplastic residual tissue after LEEP, could determine post-LEEP disease recurrence/relapse. Additionally, it is unclear whether the presence of residual HPV increases the recurrence risk of CIN. 5% of patients having recurrent CIN 3+ and CIN 2+ at 5 years, respectively [14]. Methods: Intraoperative endocervical sample was obtained with a cytobrush from the remained cervix of 292 patients immediately Conclusions: Age, length, circumference and width of LEEP have no effect on recurrence within 24 months after HSIL. 27, 95%CI, 0. Of the LEEP specimens, 90. Conclusions: Loop Electrosurgical Excision Procedure (LEEP) is used to treat pre-invasive HPV-mediated disease and patients are typically followed for 12 months after disease excision. Methods A retrospective cohort study included 160 patients who underwent cervical excision for treatment of HSIL between January 2014 and SPERANZA (SPERimentazione ANti HPV Zona Apuana) is a prospective clinical project designed to evaluate the clinical effectiveness of HPV vaccination after surgical treatment (LEEP) in women with high grade cervical intraepithelial neoplasia and microinvasive cervical cancer. Methods HPV DNA positive 37 patients (25 CIN 2–3 and 12 CIN 1 cases proven by Figure 5 Kaplan–Meier curves for residual and recurrence risk after LEEP for high-grade CIN in premenopausal women. Depending on your situation, your provider may recommend more frequent Pap smears or HPV tests to ensure no new abnormal cell changes become cervical cancer. study did find HPV persistence to be the predictor of recurrence in patients who had excision (95 %CI: 1. Moreover, CIN 3 and cold coagulation were factors affecting abnormal cervical cytology after LEEP (adjusted hazard ratios, 1. However, when HPV was residual, the recurrence rate of CIN significantly increased to 18%, even if the margins were negative. Combined with the literature review, we believe that patients aged ≥50 years, with ≥3 pregnancies and births, a history of smoking, and consistent genotypes of The recurrence of cervical dysplasia after LEEP is also related to HPV persistence. Methods: Between January 2007 and February 2013, 206 . 7% for women with negative and positive margins, respectively (p Fan et al. There are two groups - vaccination group (76), who were vaccinated with LEEP with bivalent / quadrivalent HPV-vaccine at the time of treatment, and non-vaccination group (37), which were performed LEEP and Objective: To assess the role of human papillomavirus (HPV) testing and cytology as predictors of residual/recurrent disease after treatment of high-grade cervical intraepithelial lesions. Six months after PDT, the overall HPV clearance rate was 59. Totally 415 patients with CIN ≥ Objective: The aim of the study was to evaluate the relationship between bacterial vaginosis (BV) and relapse of cervical intraepithelial neoplasia grade 2 or more (CIN2+) after Loop Persistent detection of HPV infection after conization/LEEP is one of the risk factors for recurrence or residual disease [5, 8, 11, 12]. 3% and 1. 90 and 0. HPV persistence is the only factor associated with an increased risk of recurrence after either This meta-analysis found that the recurrence rate of CIN without residual HPV and with negative margins after LEEP was quite low, at 0. Little is known about the effect of HPV vaccines on women with CIN who already are HPV infected and CIN. The residual rate of HPV and the recurrence rate of CIN after LEEP with negative margins: A meta-analysis. During these visits, a Papanicolaou (Pap) smear test was taken, colposcopy was performed and specimens were collected for HPV testing. 16, 489–491. 35, 95 % CI 1. A French retrospective study with a five-year follow-up period [ 10 ] also pointed out that the persistence of HPV after cervical conization was directly associated with an increased risk of The conclusion of a recent meta-analysis was that hr-HPV results were more accurate than margin status in predicting recurrence, with higher sensitivity (91% vs 56%) and equivalent specificity (84%). Clinically, combining Patients without HPV vaccination had a higher CIN2+ recurrence rate (OR = 12. 3969/j. HPV persistence and association with recurrent cervical intraepithelial neoplasia (CIN) after cryotherapy vs. Moreover, HPV vaccination after LEEP indeed showed a significant protective role in the prevention of high-grade squamous intraepithelial lesion (HSIL) recurrence, as patients without HPV vaccination had a higher recurrence rate (OR = Detection of residual/recurrent cervical disease after successful LEEP conization: the possible role of mRNA-HPV test Curr Pharm Des. In other follow-up programs, 30 days after LEEP, at 2 and 6 months after 1st dose: 536 patients: Reduced risk of subsequent HSIL recurrence by 81. 3% and 2. 0%, respectively. The aim of this retrospective study was to [1–2]Cervical intraepithelial neoplasia (CIN) recurrence after treatment ranges between 5 and 25% of cases [1,2]. reviewing data of more than 500 patients having conization observed that positive margins and persistence of HPV after treatment determinate a 6- and 20-fold increase in the risk of recurrent disease, The risk of CIN2+ recurrence was estimated by the incidence rate ratio using Poisson regression with adjustment for comorbidities, smoking status, nulliparity, CIN grade, positive cone margin, and HPV genotypes. Multivariate analyses showed that IOP-HPV positive, post-menopause and preoperative HPV multiplex infection was strongly associated with HPV persistence after LEEP, IOP-HPV positive and post-menopause was also associated with residua or recurrent disease after LEEP. 26 HR-HPV infection, including HPV-16, HPV-18, HPV-31, HPV-33, HPV-56, and HPV-58, significantly promotes the progression and recurrence of HSIL according to our If you’ve received an abnormal Pap test result, your doctor may prescribe a LEEP procedure, which is short for loop electrosurgical excision procedure. The value of age as a factor that favors HPV persistence after LEEP is a subject of controversy. Citation 26 HR-HPV infection, including HPV-16, HPV-18, HPV-31, HPV-33, HPV-56, and HPV-58, significantly promotes the progression and recurrence of HSIL according to our previous studies. 0% at the 3-month, 6-month, 12-month and 24-month follow-ups, Human papillomavirus (HPV) infection is one of the most common sexually transmitted viral diseases. 003) and LEEP (p =0. CrossRef Full Text | Google Scholar. We found that the cure, recurrence, and HPV clearance rates of the two HSIL treatment methods were similar. Results: In our study, the rate of persistent infection At 12 months after treatment, type-specific persistence of baseline hrHPV was significantly higher after cryotherapy compared with LEEP for any hrHPV (97 of 160 [61%] vs 82 of 166 [49%]; P = Although LEEP does not completely eradicate HPV infection, our results indicate that most HR-HPV infections are cleared after LEEP with negative margins. 21% (45/76). 003) and LEEP (p = 0. Results Irrespective of causal HPV type, 36 (4. peristent HPV 16 infection and positive margin, to have a recurrence. 23% vs. We investigated whether gene signatures could (i) associate with HPV cervical While HPV testing is currently being integrated into primary screening, the role of HPV testing in the post-treatment setting is also being explored. 008. 95% and 89. Human papillomavirus (HPV) infection is one of the most common sexually transmitted viral diseases. 0%, 21. HPV persistence increase the risk of recurrence either after LEEP and laser conization. Several previous studies have primarily The prevalence of minor bleeding in patients treated with cryotherapy was 0. Figure 2 shows post-treatment CIN2+ stratified by antecedent screening test and by whether treated histology was CIN2 or CIN3/AIS. 9% (29/182) with 94% (17/18) of the recurring disease occurring within 18months of follow up. Loop electrosurgical excision procedure Background The standard treatment for cervical adenocarcinoma in situ (AIS) is hysterectomy, which is a more aggressive treatment than that used for squamous The level of protection against CIN2+ recurrence of any high-risk HPV genotypes, achieved by post-excision vaccination, X, Sun W, Dong Y, Liu H, et al. Conclusions. Results: In our study, the rate of persistent infection from HPV 16, after LEEP, was 15. Even women in long-term monogamous relationships can get reinfected. Among the antecedent screening tests, ASC-H was grouped with HSIL and AGC because of its high risk as diagnosed at KPNC. 8% of the development of lower genital tract dysplasia. Median HPV persistence tended to decrease with increasing follow-up time, declining from 27% at 3 months after treatment to 21% at 6 months, 15% at 12 months, and 10% at 24 months. HPV persistence was the only factor associated with [5-] year recurrence after both laser conization (p = 0. 6% and 5. 81 (1. 8% (n = 258) demonstrated HSIL and 3. RESULTS:In our study, the rate of persistent infection A recent long-term follow-up study conducted by Bogani et al. After a median follow-up of 26. 0% at the 3-month, 6-month, 12-month and 24-month follow-ups, respectively. A retrospective cohort study of 218 patients with positive margin after conization, including cold knife conization (CKC) and loop electrosurgical Objective: This study was conducted to determine, using the HPV DNA Chip (HDC) test, whether the human papillomavirus (HPV) genotype is predictive of recurrent high-grade cervical intraepithelial neoplasia (CIN; CIN2-3) after a loop electrosurgical excision procedure (LEEP) in postmenopausal women. Persistent high-risk human papillomavirus (HR-HPV) infection is a significant predictor for post-conization recurrence, making HPV testing alongside cytology essential in The vaccination group received the first dose at 1 week after LEEP and the remaining two doses two and six months later. Materials and methods: The clinicopathological and follow-up data of 76 women with hr-HPV persistent A positive margin after LEEP is defined as the histopathologic presence of any grade CIN along the margin of the LEEP specimen after the procedure. Logistic regression was used to determine odds of recurrence. 10–13 While HPV testing is currently being integrated into primary screening, the role of HPV testing in the post-treatment setting is also being explored. Keywords: LEEP, Follow-up, Colposcopy, HSIL, CIN2–3, HPV Background To evaluate the diagnostic value of combining HPV E6/E7 mRNA testing with Thin-Prep cytology (TCT) for residual/recurrence detection, a total of 289 patients who underwent loop electrosurgical excision procedure (LEEP) for high-grade cervical lesions were included. 3 A meta-analysis revealed that the rates of CIN recurrence at the 12-month follow-up after LEEP were approximately 26. The state of the margin is generally considered to be a risk factor for recurrence or For patients with positive ECC before LEEP, involved margins, HPV infection, and abnormal LCT after treatment, ECC should be included in the follow-up strategy. 3 years) After CIN II or CIN III treatment, the majority of patients (82. HPV and cervical carcinogenesis HPV is a small, non-encapsulated, double-stranded DNA Objective: The aim of the study was to evaluate the relationship between bacterial vaginosis (BV) and relapse of cervical intraepithelial neoplasia grade 2 or more (CIN2+) after Loop electrosurgical excision procedure (LEEP). Results: A total of 15,177 women underwent treatment for CIN 3 (n = 14,668) and AIS (n = 509). and Tan et al. 04. Cancer. After conducting the meta-analysis of the studies, the risk of minor bleeding during the first 24 hours after treatment in cryotherapy versus LEEP patients was not statistically significant (RR 0. 84 (1335–6042) P < 0. With the younger age of female patients with lower genital tract diseases, the demand for preserving normal organ structure and protecting fertility in disease treatment is increasing, and an effective, minimally invasive, and less adverse treatment is Older age, persistent HPV infection after conization/LEEP, location of the involved resection margin, According to Kocken et al. , depth, thickness and maximum diameter), histology of the first LEEP specimen and ECC specimen, number and location of involved margin sections, cervical cytology results, high-risk HPV results, biopsy and ECC findings during follow-up, and histology from Likewise, recent studies have shown that HPV test negativity after dysplasia removal was a major predictor of treatment success [11]. firmed CIN2/3 who underwent LEEP in 2015–2020. The type of surgical approach did not influence HPV persistence. Additional HPV After tissue-preserving LEEP, there is an increased risk of vaginal infections and PROM at term in consecutive pregnancy. The HPV negative conversion rates in patients ≤ 50 years old group and > 50 years old group were 68. 39 to 0. Follow-up HPV testing ranged from 1. HPV test results at 3 and 6 months after treatment were comparable. 001). 41 Another study revealed that, in a high-risk population undergoing cervical conization for high-grade cervical lesions with positive The conclusion of a recent meta‐analysis was that hr‐HPV results were more accurate than margin status in predicting recurrence, with higher sensitivity (91% vs 56%) and equivalent specificity (84%). It is so common that most people who are sexually active will get it at some point and not realize After a median follow-up of 33 months (range: 1–94 months), persistent/recurrent lesions were found in 50 patients (approximately 10%). We found that a correctly performed LEEP conization may contribute to the remission of persistent HPV infection; a more extended follow-up period might be recommended due to a high rate of Patients can return to work one to two days following a LEEP, and can return to exercise soon after, depending on instructions from their care team. The 5-year risks of developing CIN2+ after treatment depended both on antecedent screening test and the A total of 284 patients were included. 96)p < 0. Moreover, HPV HPV infections can persist and recur. 7% and 66. It was found that Post-LEEP follow-up HPV, Post-LEEP follow-up TCT, and the Gland involvement were independent risk factors for residual lesions in CIN3 patients after LEEP (all p < 0. Introduction Human papillomavirus (HPV) infections are responsible for the majority of cervical [13]. issn. 5%. In one study, the risk of recurrence or residual Conclusion: Preoperative PLR level and HR-HPV infection could be available markers for predicting recurrence/residual disease of HSIL after LEEP. 8%), and that the with loop electrosurgical excision procedure (LEEP) and follow-up visits took place at 6 weeks, 6 months, 1 year and 2 years. However, no meta-analysis has shown the residual rate of HPV or the recurrence rate of CIN after LEEP with negative margins. Infected women may develop cervical cancer after several years or even more than ten years []. Kechagias KS, Kalliala I, Bowden SJ, et al. electrosurgical excision procedure (LEEP). 1% and 4% after LEEP and laser conization, respectively (p = 0. Although LEEP does not completely eradicate HPV infection, our results indicate that most HR-HPV infections are cleared after LEEP with negative margins. Fan et al. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24 months during the first 2 years and yearly thereafter. 9% (n = 11) had adenocarcinoma in situ. 84 and 0. But there was no significant difference in HPV clearance rate between the HPV16/18 infection group and other hr-HPV Methods . 17% of patients developed a High-grade squamous intraepithelial lesion (HSIL) is a squamous cell abnormality associated with human papillomavirus (HPV). Objective: The purpose of this study was to determine the predictive factors for residual/recurrent disease and to analyze the timing for Pap smears and human papillomavirus (HPV) testing during follow-up after loop electrosurgical excision procedure (LEEP) for cervical intraepithelial neoplasia (CIN) 2 or worse. Mod. Previous article persistent lesions are defined as those that worsen and are found again <6 months after LEEP. also showed that some patients have persistent HPV infection or cytologic abnormalities after LEEP, a high-risk factor for HSIL recurrence and progression. 2% of patients, Five-year recurrence rate was 8. 1136/bmj-2022-070135 [PMC free article] [Google Scholar] 9. LEEP does not affect prematurity or miscarriage. Patients are advised to Multivariate analysis showed that no vaccination after LEEP was an independent risk factor for recurrent CIN2-3 (HR=2. The consistency index (C-index) of the nomogram model for predicting residual lesions was 0. The residual rate of HPV was 22. The median follow-up time was 19 months. The role of HPV in cervical cancer has led to the incorporation of HPV testing into primary screening programs, 4, 8, 10, 11 which has increased sensitivity and negative predictive value when compared to cytology alone. 2% Strander B. 11 A retrospective study showed that postoperative hr-HPV results had high sensitivity (88. , Sasieni P. 17% during the 6–12 months follow-up). However, compared with ablation, LEEP requires highly skilled medical personnel and expensive equipment, produces odor and possible viral-laden smoke, and increases the risk of preterm labor in subsequent pregnancies in The study aimed to compare the effectiveness between Hiporfin-photodynamic therapy (PDT) and loop electrosurgical excision procedure (LEEP) in treating cervical high-grade squamous intraepithelial The demographic characteristics were middle aged multiparous women who all had cervical pathology CIN2/3 prior LEEP. 62, p = 0. Analysis of factors associated with regression after LEEP treatment for cervical intraepithelial neoplasia. A normal test result may also be called a negative test result or negative for intraepithelial lesion (area of abnormal growth) or malignancy. , depth, thickness and maximum diameter), histology of the first LEEP specimen and ECC specimen, number and location of involved margin sections, cervical cytology results, high-risk HPV results, biopsy and ECC findings during follow-up, and histology from INTRODUCTION. 29 reporting a higher risk for recurrence in women with a persistent HPV genotype. Several investigators have analyzed the sensitivity and specificity of HPV DNA testing compared with This study was to identify the predictors of recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN) after cervical conization. Crossref. Patients were followed up at different time points, and residual/recurrent lesions were confirmed Information that was collected included patient characteristics, details regarding the initial LEEP specimens (e. 7 months (range 6–100), 64 (22. It encompasses the previously used terms Purpose Conization for suspected high grade cervical intraepithelial neoplasia (CIN) is often performed based on abnormal cytology only. Methods This retrospective study identified 421 patients with histologically confirmed CIN 3 who underwent LEEP and subsequently had a hysterectomy within 6 months. Conclusions: Age, length, circumference and width of LEEP have no effect on recurrence within 24 months after HSIL. Anal cancer is rare in the general population (1–2 cases per 100,000 person-years); however, incidence is substantially higher among Emmanouil Papasavvas, Andrew V Kossenkov, Livio Azzoni, Nicola M Zetola, Agnieszka Mackiewicz, Brian N Ross, Matthew Fair, Surya Vadrevu, Doreen Ramogola-Masire, Ian Sanne, Cynthia Firnhaber, Luis J Montaner, Gene expression profiling informs HPV cervical histopathology but not recurrence/relapse after LEEP in ART-suppressed HIV + HPV + Recurrence rate 1-5 years after treatment was defined as a biopsy finding of CIN 3/AIS or retreatment (loop electrosurgical excision procedure [LEEP], laser, cone, hysterectomy). 9% of the women who developed cervical cancer were still in the colposcopy clinic after two years of follow-up, implicating that they persisted with cervical abnormalities. When considering other procedures, HPV testing may offer adequate sensitivity for predicting recurrence, while HPV genotyping seems helpful in increasing the post-treatment predictive value [11]. , explains what a LEEP is, what to expect, whether it hurts, what the recovery looks like and more. 918). 919-79. In our study, 16. Conclusions HPV persistence is the only factor associated with an increased risk of recurrence after either laser conization or LEEP. The primary objective of the project is to verify if vaccination after surgery could reduce Aim: To seek the high-risk factors of human papillomavirus (HPV) persistence and residual lesion or recurrence after loop electrosurgical excision procedure (LEEP) focus on the predictive value of intraoperative human papilloma virus (IOP-HPV) testing. 9%) patients presented persistent HPV infection. 82. 008). Clinically, combining PLR with HR-HPV tests may provide novel evaluation method and reference for management in post-treatment patients with cervical precancerous les Likewise, recent studies have shown that HPV test negativity after dysplasia removal was a major predictor of treatment success [11]. 0%, 15. 17% of patients developed a CIN recurrence requiring further cervical surgery. 0% and 10. The vaccination group received the first dose at 1 week after LEEP and the remaining two doses two and six months later. Post-LEEP follow-up was performed at 3, 6, 9, A total of 284 patients were included. From this study it For patients with positive ECC before LEEP, involved margins, HPV infection, and abnormal LCT after treatment, ECC should be included in the follow-up strategy. High-risk (hr-) HPV Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. 1671-332X. 01: CIN2 or CIN3 at 3‐month follow‐up visit was considered as residual disease and patients were excluded: Sand et al. 962–0. g. 3%) were negative for HPV infection at the first follow-up, and the 5-year risk for recurrence of CIN III+ was approximately 0. Because most AIS lesions are caused by HPV 16/18 infection, prophylactic HPV vaccination is an important step toward prevention of AIS, potentially reducing the incidence of Both randomized and non-randomized studies demonstrate a failure rate of 5–30% for laser ablation and 5–16% for LEEP in a 6-month follow-up period; 7, 8 however, in 2002, A recent long‐term follow‐up study conducted by Bogani et al. Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: Systematic review and meta-analysis. Methodology In 2010–2018 we performed 106 loop electrosurgical excision procedures (LEEP) in patients of reproductive age with histological confirmation of HSIL. The recurrence of cervical dysplasia after LEEP is also related to HPV persistence. Objective: Review of the literature addressing the question whether adjuvant vaccination with an HPV-vaccine in addition to LEEP treatment is effective in preventing recurrence of CIN-lesions. Role of human papillomavirus (HPV) vaccination on HPV infection and recurrence of HPV related disease after local surgical treatment: systematic review and meta-analysis. 2022;378 A recent long-term follow-up study conducted by Bogani et al. Surgeons should make every effort to obtain free margins during LEEP, and human papillomavirus testing may be the most useful method for predicting recurrence during surveillance. Gynecologic oncologist Kathleen Schmeler, M. Moreover, HPV To evaluate the risk factors of recurrent high-grade cervical intraepithelial neoplasia grade 2 or worse (CIN2+) after loop electrosurgical excision procedure (LEEP). HPV vaccine decreased CIN2+ It’s not always possible to completely prevent HPV-related warts from coming back, but there are steps you can take to help minimize how often they recur. Background The standard treatment for cervical adenocarcinoma in situ (AIS) is hysterectomy, which is a more aggressive treatment than that used for squamous intraepithelial lesions. (p < 0. Differential Analysis of Pregnancy Outcomes After Treatment of HIFU and LEEP in Patients with Cervical However, no meta-analysis has shown the residual rate of HPV or the recurrence rate of CIN after LEEP with negative margins. The reference group consisted of 956 singleton births. PATIENTS AND METHODS:One hundred four patients who underwent LEEP for CIN2+ were fol-lowed up every six months for three years. Objective: To evaluate the efficacy and safety of photodynamic therapy (PDT) in women with high-risk human papillomavirus (hr-HPV) persistent infection after cervical conization, including loop electrosurgical excision procedure (LEEP) and cold knife conization (CKC). The persistence of HPV16 for the first 18 months strongly correlates with the risk of developing a CIN2+ recurrence. 026) (Table 2). 5% (n = 81) of the LEEP specimens had positive margins. Patients and methods: One hundred four patients who underwent LEEP for CIN2+ were followed up every six months for three years. Conclusions When considering other procedures, HPV testing may offer adequate sensitivity for predicting recurrence, while HPV genotyping seems helpful in increasing the post-treatment predictive value [11]. HPV Risk of cervical intraepithelial neoplasia grade 2 or worse after conization in relation to HPV vaccination status. 01). 1%). Positive margins are associated with higher rates of persistence and recurrence of CIN compared with negative margins; however, a stronger predictor for persistent high-grade dysplasia is HPV status. Adenocarcinoma in situ (AIS) of the uterine cervix is caused by infection with high-risk human papillomavirus and is the recognized precursor of invasive adenocarcinoma of the cervix. The recurrence or residual disease rate after treatment is up to 17%. Purpose To evaluate the risk factors associated with persistent high-risk human papillomavirus (HR HPV) infections in patients undergoing cervical excision for treatment of high-grade squamous intraepithelial lesion (HSIL). Methods: This retrospective study included patients with histopathologically confirmed CIN2/3 who underwent LEEP in 2015-2020. Int. 2013;19(8) they evaluated the diagnostic accuracy of E6/E7 mRNA test as predictive marker of recurrence. Costa et al 2003 and Sarian et al 2004 found that women older than 35 years old had a significantly higher risk for HPV persistence after LEEP [15, 16]. Results: HPV infection was detected in 31% of patients at 6-month follow-up and in 11. . Future efforts should evaluate the impact of HPV vaccination on long-term outcomes after see-and-treat LEEP for HSIL cytology. There are two groups - vaccination group (76), who were vaccinated with LEEP with bivalent / quadrivalent HPV-vaccine at the time of treatment, and non-vaccination group (37), which were performed LEEP and To evaluate the diagnostic value of combining HPV E6/E7 mRNA testing with Thin-Prep cytology (TCT) for residual/recurrence detection, a total of 289 patients who underwent loop electrosurgical excision procedure (LEEP) for high-grade cervical lesions were included. colposcopic follow up visit after treatment, in a setting which frequently utilizes laser ablation in combination with LEEP, for large lesions. Between January 1999 and December 2009, 282 patients fulfilled the inclusion criteria and were included in the final statistical analysis. Recurrence rate after loop electrosurgical excision procedure (LEEP) and laser conization: a 5-year Objective: The aim of this meta-analysis was to discuss evidence supporting the efficacy of adjuvant human papillomavirus (HPV) vaccination in reducing the risk of recurrent cervical intraepithelial neoplasia (CIN) 2 or greater after surgical treatment. Those with an abnormal HPV test are at a higher risk of developing high Results. Giorgio Bogani. 2024, PLoS ONE. The CIN2+ recurrence rates in 147 women enrolled in the analysis were 18 and 2 cases per 100,000 person-days for unvaccinated and Background About 23% of patients develop CIN2+ after LEEP treatment due to residual or recurrent lesions. Aims: This study aims to evaluate whether the preconisation of high-risk human papillomavirus (HR-HPV) genotype and multiple HPV infection is predictive for residual/recurrent disease during the follow-up of high-grade cervical intraepithelial neoplasia (CIN) treated by loop electrosurgical excision procedure (LEEP) with negative margins. Cox regression model was used to compare the effect of FUS and LEEP on HPV clearance after adjustment of age, cervical cytology, HR-HPV types, educational background, marital status, age of first Sopracordevole F, et al. This recurrence rate is consistent with most published literature on recurrence rates of CIN2/3. , 2019, Denmark 14 Background/purpose This study aims to investigate whether women with cervical dysplasia after LEEP have an increased risk of pregnancy/childbirth complications or recurrence of dysplasia in an upcoming pregnancy. Human papillomavirus (HPV) is one of the foremost sexually transmitted viruses among young women around the world []. We should refine other aspects about marriage, but there is not enough data. In a randomized clinical trial, HPV-associated lesions Multivariate analyses showed that IOP-HPV positive, post-menopause and preoperative HPV multiplex infection was strongly associated with HPV persistence after LEEP, IOP-HPV Here, we aimed to compare the recurrence rate following laser conization and loop electrosurgical excision procedure (LEEP) in patients with high-grade cervical dysplasia How likely is HPV to return after LEEP? A LEEP procedure cannot cure HPV, although it can effectively eradicate the precancerous cell growth that the virus can cause. Five-year recurrence rate was 8. 2020; 147:641-647. Preoperative PLR level and HR-HPV infection could be available markers for predicting recurrence/residual disease of HSIL after LEEP. 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