Impact of the human papillomavirus vaccination on patients who underwent conization for high-grade cervical intraepithelial neoplasia

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.