Cervical vaporization in LSIL and persistent HPV infection

Area of Science:

• Gynecology
• Oncology
• Virology

Background:

• Persistent high-risk human papillomavirus (HPV) infection and low-grade squamous intraepithelial lesions (LSIL) of the cervix are significant public health concerns.
• Cervical intraepithelial neoplasia (CIN) grade I that persists for over two years requires effective treatment to prevent progression.
• CO2 laser vaporization is an established outpatient procedure for managing cervical dysplasia.

Purpose of the Study:

• To evaluate the efficacy of CO2 laser vaporization in achieving negative cytology and high-risk HPV testing.
• To identify patient-related factors influencing treatment success rates.
• To assess the long-term outcomes of CO2 laser treatment for persistent high-risk HPV and LSIL.

Main Methods:

• A cohort of 124 patients with persistent high-risk HPV or LSIL (CIN I) underwent CO2 laser vaporization between February 2011 and January 2015.
• Data collected included patient demographics, parity, condom use, oral contraceptive use, smoking status, HPV vaccination, and immune status.
• Cytology and high-risk HPV testing were performed at 6 months post-treatment, with extended follow-up for a subset of patients.

Main Results:

• At 6 months, 79% of 116 treated patients achieved negative cytology, and 60% had negative high-risk HPV tests; both normalized in 54%.
• Negative high-risk HPV testing was significantly associated with younger age (<45 years), non-HPV 16/18 types, nulliparity, and condom use.
• Among patients with persistent HPV infection and abnormal cytology at 6 months, only 14.7% achieved negative high-risk HPV results by the end of follow-up.

Conclusions:

• CO2 laser vaporization is a simple, safe, and effective outpatient treatment for persistent high-risk HPV and low-grade cervical lesions.
• While cytology often normalizes, achieving negative high-risk HPV status requires longer follow-up and may be influenced by specific patient factors.
• The procedure can be performed without anesthesia, contributing to its practicality and patient acceptance.