Introduction/Background Women who have been treated for high-grade squamous intraepithelial neoplasia (HSIL) face an elevated risk of recurrence and invasive cervical cancer. The likelihood of recurrence depends on the grade of dysplasia, the treatment used, persistence of high-risk human papillomavirus (HR-HPV) and the woman's age. We represent our experience in performing HPV-vaccination in previously unvaccinated women of reproductive age at the time of treatment cervical HSIL in order to prevent recurrent disease.
Methodology In 2010–2018 we performed 106 loop electrosurgical excision procedures (LEEP) in patients of reproductive age with histological confirmation of HSIL. 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 followed without vaccination. The vaccination group received the first dose at 2 month before LEEP and the remaining two doses at the same day of LEEP and four months later. Women had post-operative surveillance with cytology and colposcopy at 3, 6, 9, 12, 18 and 24 months, and yearly thereafter. Also HPV DNA tests were performed in order to determine if the persistence of HR-HPV infection is associated with the development of recurrent HSIL.
Results In the vaccination group (76 patients), 7 patients (9.2%) developed recurrence, whereas 6 patients (16.7%) in the non-vaccination group (37 patients) developed recurrence. In patients infected with HPV of 16 and/or 18 type, 2 patients (2.6%) in the vaccination group (76 patients) and 3 patients (8.1%) in the non-vaccination group (37 patients) developed recurrent disease related to vaccine HPV types after LEEP.
Conclusion HPV-vaccine can be used in prevention of recurrent HSIL at the time of treatment by LEEP. The persistence of HR-HPV infection is associated with the development of recurrent HSIL and can be reduced by combination of HPV-vaccination and LEEP.
Disclosure Nothing to disclose
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