J Cancer 2016; 7(1):107-114. doi:10.7150/jca.13503


HPV-Testing in Follow-up of Patients Treated for CIN2+ Lesions

Luciano Mariani1,✉, Maria Teresa Sandri2, Mario Preti3, Massimo Origoni4, Silvano Costa5, Paolo Cristoforoni6, Fabio Bottari2, Mario Sideri

1. HPV-UNIT, Regina Elena National Cancer Institute of Rome, Italy
2. Division of Laboratory Medicine, European Institute of Oncology, Milan, Italy
3. Department of Obstetrics and Gynecology - University of Turin, Italy
4. Obstetrics and Gynecology Unit, Vita-Salute San Raffaele University and IRCCS San Raffaele Hospital, Milan, Italy
5. MF Toniolo Hospital, Bologna, Italy
6. Villa Montallegro, Genoa, Italy
† Deceased

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Mariani L, Sandri MT, Preti M, Origoni M, Costa S, Cristoforoni P, Bottari F, Sideri M. HPV-Testing in Follow-up of Patients Treated for CIN2+ Lesions. J Cancer 2016; 7(1):107-114. doi:10.7150/jca.13503. Available from http://www.jcancer.org/v07p0107.htm

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Persistent positivity of HPV-DNA testing is considered a prognostic index of recurrent disease in patients treated for CIN2+. HPV detection, and particularly genotyping, has an adequate high rate of sensitivity and specificity (along with an optimal reproducibility), for accurately predicting treatment failure, allowing for an intensified monitoring activity. Conversely, women with a negative HPV-test 6 months after therapy have a very low risk for residual/recurrent disease, which leads to a more individualized follow-up schedule, allowing for a gradual return to the normal screening scheme. HPV testing should be routinely included (with or without cytology) in post-treatment follow-up of CIN2+ patients for early detection of recurrence and cancer progression. HPV genotyping methods, as a biological indicator of persistent disease, could be more suitable for a predictive role and risk stratification (particularly in the case of HPV 16/18 persistence) than pooled HPV-based testing. However, it is necessary to be aware of the performance of the system, adhering to strict standardization of the process and quality assurance criteria.

Keywords: CIN recurrence, HPV-testing, genotyping, CIN2+, follow-up