The Value of HPV-HR DNA Testing During the Follow-Up After Treatment of CIN3/AIS

Up to 30 % of women treated for a preinvasive cervical disease are diagnosed with a residual/recurrent disease including an invasive carcinoma during follow-up. Studies have shown a higher sensitivity in detection of residual/recurrent disease with the use of combined testing (cytology and HPV. One hundred and thirty five patients treated with cold-knife conization (CKC) or large loop excision of the transformation zone (LLETZ) for a preinvasive cervical disease, were enrolled in the study. The follow-up consisted of cytology, colposcopy with biopsy if needed and HPV testing. Only patients with at least two cytology smears and one HPV test during the first two post-treatment years remained in the study. The HPV test was performed by EIA PCR and by Line immuno Probe Assay. The statistic analysis was performed using the χ2 test. Results of our study suggest that in our setting the best approach is to have a first control cytology smear 6 months after conization. HPV test should be done in patients with a positive smear any time during follow-up as the point of decision for a second treatment. With this approach we could considerably decrease the number of reoperated patients and co-morbidities without decreasing the quality of follow-up.