P11-04EVALUATION OF THE PERSISTENCE OF HPV GENOTYPES IN WOMEN TREATED FOR CIN2+ LESIONS

11. Genotyping
F. Bottari 1, S. Boveri 2, C. Gulmini 1, A.D. Iacobone 2, E. Preti 2, N. Spolti 2, L. Mariani 3, F. Landoni 2, M. Preti 4, M.T. Sandri 1.
1European Institute of Oncology, Division of Laboratory Medicine, Milan, Italy (Italy), 2European Institute of Oncology, Unit of Preventive Gynecology, Milan, Italy (Italy), 3Regina Elena National Cancer Institute, HPV-Unit, Gynecologic Oncology, Rome, Italy (Italy), 4Department of Obstetrics and Gynecology, University of Torino, Turin, Italy. (Italy)

Background / Objectives

The follow-up of women treated for CIN lesions includes HPV testing and cytology, with different schedules depending on different guidelines. Today it is not yet clear if looking at the persistence of the genotype identified at baseline (before any treatment) would be of help in selecting those women who may present a relapse, while reassuring those cured by the surgical conservative treatment. Aim of this study was the evaluation of the utility of using a test giving an extended genotyping in the follow-up of patients treated for CIN2+ lesion. 


Methods

One hundred and sixty-seven women scheduled to be conservatively treated for a CIN2+ lesion were enrolled. For all the patients a cervical sample was taken before treatment and at first follow-up visit. In all the patients the results of histology performed at baseline and at relapse (when occurred) was available. The presence of HPV DNA was evaluated with the BD Onclarity HPV assay, which allows an extended genotyping, detecting HPV16, 18, 31, 45, 51 and 52 in single, and HPV 33/58, 35/39/68 and 56/59/66 in pool. In all the patients results of cytology, hc2 and Linear Array were also available.


Results

Of the 167 patients, 161 had the Onclarity performed also at the first follow-up visit. A negative HPV test was found in 120 women, while 41 tested positive (25.5%): 14 cases presented different genotypes from baseline, while 27 of 41 (65.8%) showed fully or partially persistence. Nine patients (5.4%) relapsed and Onclarity was performed at baseline and follow up in 7 of them: 6 had persistence of the same genotypes, while 1 patient tested negative not only with Onclarity but also with hc2. In this patient cytology was HSIL, and Linear Array HPV test revealed the presence of HPV18 and 73 at baseline, with the persistence of HPV73 at relapse. 


Conclusion

This study showed that the inclusion of the evaluation of the HPV genotype specific persistence may represent a valid option to follow patients treated for CIN2+ lesions. In our study we found that relapses were detected only in patients with persistence of the same genotype detected at baseline.  


References