Intraoperative Human Papillomavirus Test Predicts 24-Month High-Grade Squamous Intraepithelial Lesion Recurrence Saving Costs: A Prospective Cohort Study.
J Low Genit Tract Dis
; 24(4): 367-371, 2020 Oct.
Article
en En
| MEDLINE
| ID: mdl-32569022
ABSTRACT
OBJECTIVES:
The human papilloma virus (HPV) test is recommended in the posttreatment follow-up of cervical intraepithelial neoplasia. The aim of the study was to assess whether the intraoperative HPV (IOP-HPV) test had a similar diagnostic accuracy that HPV test performed at 6 months to predict high-grade squamous intraepithelial lesion (HSIL) recurrence. MATERIALS ANDMETHODS:
In a prospective cohort study, 304 women diagnosed with HSIL by biopsy and/or endocervical curettage before treatment and/or confirmation in the histological specimen were included. Immediately after surgery, HPV testing was performed. This test was compared with the test at 6 months and other predictors of recurrence. Patients were followed for 24 months. An economic analysis was performed to compare the costs of IOP-HPV and HPV test at 6 months.RESULTS:
Recurrence rate of HSIL was 6.2% (19 patients). The diagnostic accuracy of the IOP-HPV test to predict HSIL recurrence at 24 months was similar to the HPV test at 6 months, with comparative sensitivities of 100% versus 86.7%, specificities of 82.0% versus 77.9%, positive predictive values of 27.1% versus 18.1%, and negative predictive values of 100% versus 99.0%. Direct economic saving per high-grade intraepithelial lesion patient was 172.8 &OV0556;.CONCLUSIONS:
The HPV test performed after loop electrosurgical resection procedure predicted recurrence of HSIL at 24 months with a similar diagnostic accuracy than the HPV test at 6 months. The use of the IOP-HPV test in the management of HSIL will allow early detection of the risk of recurrent disease and to save costs because of potential suppression of the need of HPV and follow-up controls at 6 months.
Texto completo:
1
Banco de datos:
MEDLINE
Asunto principal:
Papillomaviridae
/
Prueba de Papanicolaou
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Lesiones Intraepiteliales Escamosas de Cuello Uterino
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Recurrencia Local de Neoplasia
Tipo de estudio:
Diagnostic_studies
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Etiology_studies
/
Health_economic_evaluation
/
Incidence_studies
/
Observational_studies
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Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Límite:
Adult
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Female
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Humans
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Middle aged
País como asunto:
Europa
Idioma:
En
Año:
2020
Tipo del documento:
Article