Is vaccination with quadrivalent HPV vaccine after loop electrosurgical excision procedure effective in preventing recurrence in patients with high-grade cervical intraepithelial neoplasia (CIN2–3)?

Abstract

AbstractObjectivesThis study was conducted to determine whether vaccination with the quadrivalent human papillomavirus (HPV) vaccine after loop electrosurgical excision procedure (LEEP) for high-grade cervical intraepithelial neoplasia (CIN2–3) is effective in preventing recurrence of CIN2–3.MethodsBetween August 2007 and July 2010, 737 patients aged 20–45years who were diagnosed with CIN2–3 were treated by LEEP and followed. Three hundred and sixty patients were vaccinated with the quadrivalent HPV vaccine after LEEP (vaccination group), and 377 patients were followed without vaccination (non-vaccination group). The vaccination group received the first dose at 1week after LEEP and the remaining two doses two and six months later. Post-LEEP follow-up was performed at 3, 6, 9, 12, 18, and 24months during the first 2years and yearly thereafter.ResultsIrrespective of causal HPV type, 36 (4.9%) patients developed recurrence. In the vaccination group (360 patients), 9 patients (2.5%) developed recurrence, whereas 27 patients (7.2%) in the non-vaccination group (377 patients) developed recurrence. In patients infected with HPV of 16 and/or 18 type, 5 patients (2.5%) in the vaccination group (197 patients) and 18 patients (8.5%) in the non-vaccination group (211 patients) developed recurrent disease related to vaccine HPV types (HPV 16 or 18 types) after LEEP (P<0.01). Multivariate analysis showed that no vaccination after LEEP was an independent risk factor for recurrent CIN2–3 (HR=2.840; 95% confidence interval, 1.335–6.042; P<0.01).ConclusionsVaccination with the quadrivalent HPV vaccine after treatment may be considered in preventing recurrence of CIN2–3