Vrijednost genotipizacije humanoga papiloma virusa u praćenju bolesnica s premalignim promjenama i početnim karcinomom vrata maternice nakon liječenja konizacijom

doctoral thesis

• Title (english): The value of HPV-HR DNA testing during the follow-up after the treatment of preinvasive disease of cervix uteri
• Author: Maja Banović
• Mentor: Damir Babić (mentor)
• Committee member: nije dostupno (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; Zagreb
• Defense date and country: 2016-03-17, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences
• Universal decimal classification (UDC): 61 - Medical sciences

Abstract

Cilj: Poboljšati učinkovitost protokola praćenja bolesnica nakon konizacije zbog
preinvazivne bolesti na vratu maternice, uz smanjenje broja reoperiranih bolesnica
definirajući vrijednost i vremenski period ponavljanja citološke pretrage i HPV DNK testa.
Ispitanice i metode: U istraživanju je sudjelovalo 114 bolesnica koniziranih zbog CIN3 i/ili
AIS-a. Kontrolni nalazi su grupirani u tri skupine intervala praćenja: prvi (3-6 mjeseci), drugi
(9-12 mjeseci) i treći (18-24 mjeseca). Uzet je uzorak za tekuću citološku analizu (engl.
liquid-based cytology, LBC) i iz tog biološkog materijala određivana je prisutnost DNK
visokorizičnog HPV-a. U slučaju pozitivnog testa određivan je zatim HPV genotip. Bolesnice
su praćene barem 24 mjeseca od primarnog operacijskog zahvata (konizacija) ukoliko nije
postavljena sumnja na rezidualnu bolest/recidiv ili do sekundarnog operacijskog zahvata.
Rezultati: Medijan praćenja bolesnica je bio 41 mmjesec (5-72 mjeseca). Specifičnost
citološkog nalaza za procjenu rezidualne bolesti/recidiva bila je 88,9%, osjetljivost 100%,
PPV 33,3%, a NPV 100%. Specifičnost HPV testa je bila 76,9%, osjetljivost 100%, PPV
21,4%, NPV 100%.
Zaključak: Prema našim rezultatima i citološki nalaz i HPV test mogu biti primarni testovi u
praćenju bolesnica nakon konizacije. U našim okvirima HPV test je potrebno učiniti samo
kod bolesnica s pozitivnim citološkim nalazom bilo kad nakon konizacije prije odluke o
potrebnom ponovnom kirurškom zahvatu.

Abstract (english)

Aims: We performed this study in order to improve diagnostic accuracy of the follow-up
protocol after a treatment for preinvasive cervical disease, at the same time reducing the
number of overtreated patients.
Patients and methods: One hundred and fourteen patients were followed up after conization
for CIN3 and/or AIS at 3-6 month, 9-12 month and 18-24 month intervals, then yearly. The
follow-up consisted of cytology, colposcopy with biopsy if needed and HPV testing. The endpoint
of the study was a secondary treatment due to a high suspicion of resdidual/recurrent
disease or disease free period of at least 24 months.
Results: The median follow-up time was 41 months (5-72 months). In predicting
residual/recurrent disease cytology had a specificity of 88.9%, sensitivity of 100%, PPV of
33.3% and a NPV of 100% whereas HPV had a specificity of 76.9%, sensitivity of 100%,
PPV of 21.4% and a NPV of 100%.
Conclusion: According to our results both tests can be used as a primary follow-up tool after
conization. The choice should depend on a socio-economic aspect. In our setting the HPV test
should be done only in those patients with a positive smear any time during follow-up as the
point of decision for a second treatment. With this approach we could considerably decrease
the number of reoperated patients and co-morbidities.

• Keywords: medicina
• Keywords (english): medicine
• Language: croatian
• URN:NBN: urn:nbn:hr:105:101378
• Study programme: Title: Biomedicine and Health Sciences; Study programme type: university; Study level: postgraduate; Academic / professional title: doktor/doktorica znanosti, područje biomedicine i zdravstva (doktor/doktorica znanosti, područje biomedicine i zdravstva)
• Type of resource: Text
• Extent: 105 str.
• File origin: Born digital
• Access conditions: Open access
• Created on: 2023-05-05 08:09:43