Effectiveness of HPV vaccination in preventing recurrent cervical intraepithelial neoplasia after excisional treatment
Objective. To evaluate the results of surgical treatment of patients with cervical intraepithelial neoplasia (CIN) using excisional techniques and post-operative implementation of a quadrivalent human papillomavirus (HPV) vaccine. Patients and methods. Excisional treatment methods were used in 150 patients with CIN: 60 patients received a quadrivalent vaccine against HPV (type 6, 11, 16, 18) after surgery and 90 patients were not vaccinated. Post-operative examination was performed 3, 6, 12, 18, and 24 months after surgery and annually thereafter. Detection of CIN within 12 months after surgery was considered as a residual lesion, and more than 12 months after surgery - as a recurrence of the disease. Results. The post-operative follow-up periods for the vaccinated patients ranged from 6 to 93 months (median: 34 months), without vaccination: 6 to 202 months (median: 54 months). Residual lesions were not revealed among vaccinated patients and were revealed in 13.3% (12/90) of unvaccinated patients (p = 0.039). Recurrence of CIN among patients with follow-up for 12 months or more was noted in 3.3% (2/60) of vaccinated patients and 34.6% (27/78) of unvaccinated patients (p = 0.016). Conclusion. Vaccination against HPV (types 6, 11, 16, 18) after excisional treatment methods has significantly (approximately ten-fold) reduced the probability of CIN recurrence and may be considered as an effective approach to improve the results of treating patients with CIN.