IMR Press / EJGO / Volume 40 / Issue 3 / DOI: 10.12892/ejgo4628.2019
Open Access Original Research
Impact of the human papillomavirus vaccination on patients who underwent conization for high-grade cervical intraepithelial neoplasia
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1 Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena. Program of Doctorate in Health Sciences, Catholic University of Murcia (UCAM), Murcia, Spain
2 Department of Obstetrics and Gynecology, Virgen de la Arrixaca University Hospital, Murcia. Catholic University of Murcia (UCAM), Murcia, Spain
3 Applied Statistical Methods in Medical Research Group, Catholic University of Murcia (UCAM), Murcia, Spain
4 Applied Statistical Methods in Medical Research Group, Catholic University of Murcia (UCAM), Murcia, Spain. Faculty of Epidemiology and Population Health, London School of Hygiene & Tropical Medicine, London, United Kingdom
5 Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena, Murcia, Spain
6 Department of Biochemestry, Santa Lucía University Hospital, Cartagena, Murcia, Spain
7 Department of Obstetrics and Gynecology, Santa Lucía University Hospital, Cartagena. Catholic University of Murcia (UCAM), Murcia, Spain
Eur. J. Gynaecol. Oncol. 2019 , 40(3), 402–407; https://doi.org/10.12892/ejgo4628.2019
Published: 10 June 2019
Abstract

Objectives: To test whether the human papillomavirus (HPV) vaccination in patients undergoing loop diathermy conization (LEEP) for high-grade intraepithelial neoplasia (CIN 2-3) is effective in preventing recurrence of CIN 2-3 in our area. Materials and Methods: A retrospective review was conducted on 242 patients undergoing LEEP for CIN 2-3 and 42.6% received the HPV vaccine (bivalent or tetravalent) immediately before or after conization. Follow up was conducted at 3, 6, 12, 18, and 24 months to detect CIN 2-3 recurrence. Results: Regardless of the HPV type, 27 (11.1%) patients developed CIN 2-3 recurrence during post-LEEP follow up. Of the 70 vaccinated with bivalent vaccine, two (2.8%) showed recurrence, of the 33 vaccinated with tetravalent vaccine, three (9%), and of the 139 unvaccinated 61 (43.9%) developed recurrence. Of the patients infected with HPV genotypes 16/18, in the non-vaccinated group, 15 (21.7%) patients had recurrence, whereas in the vaccinated group, three (5.9%) were diagnosed with recurrence (p < 0/05). The multivariate logistic regression analysis showed that the vaccination acted as a protective factor for CIN 2-3 recurrence (OR: 0.360 (95% CI: 0.125-1.000; p < 0.05). However, neither the type of vaccine nor the time of vaccination showed a significant association with the onset of recurrence. Conclusions: The HPV vaccine appears to be a recommendable preventative strategy in reducing the risk of recurrent disease for patients treated for CIN 2-3.

Keywords
Human papillomavirus
Vaccine
Cervical intraepithelial neoplasia
Recurrent disease
Conization
LEEP
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