The average age of the doctors was 43 years ranged from 36 to 54 years. The electrosurgical procedure was performed with a high-frequency electrical generator and wire loop electrodes. The loop was selected on the basis of the size of the area to be excised.
The appropriate loop electrode was applied to excise the transformation zone under colposcopic guidance. The specimen was sent for pathological examination. The operation time of the electroexcision and electrocoagulation procedure ranged from 2 min to 15 min a median of 6 min.
Of the surgeons, 93 wore a simple surgical face mask, typically containing three layers, and 41 wore a N95 surgical mask. Additionally, the local smoke evacuation system was always used during the operation. In fact, operators in different hospitals always used suction devices at different distances from the surgical site; some suction tubes were fixed on the metal vaginal speculum near the surgical sites, while others were handheld by the doctors during LEEP.
Generally, the distance of the top of the exhaust suction tube from the surgical site was approximately 2—10 cm. All participants gave their written informed consent. Physicians collected exfoliated cervical cells by a CytoBrush, which was placed into 2.
A new aseptic swab was used for each examination. In addition, preoperative and postoperative nasal swab specimens were collected from the surgeons for the detection of HPV DNA. The nasal swab specimens were obtained from both nostrils at a depth of 2—3 cm by using a sterile cotton swab, which was then placed into an Eppendorf tube containing 1. The surgeons whose nasopharyngeal wash specimens harbored detectable HPV DNA underwent a nasal swab examination after an additional 3, 6, 12, 18 and 24 months.
In addition, in operators testing positive for HPV16 or 58 in the nasopharynx, the presence or absence of HPV-related diseases such as verruca acuminate was confirmed every 3 months until December a follow-up time of 35—43 months. Then, the supernatant was removed.
Then, the whole solution was transferred to a high-purity filter tube and centrifuged at 8, rpm for 1 min. After these purification steps were repeated twice, the residual Wash Buffer was centrifuged at 13, rpm for 10 s. Then, the filter tube was inserted into a nuclease-free, sterile 1.
A positive control and a negative control were included in each PCR analysis process. In total, 40 cycles were performed. The negative control was analyzed simultaneously. Multiple dots indicated multiple infections. A digital image of the gel was acquired in a gel documentation system Bio-Rad, USA , and the specific HPV type was determined by matching the restriction fragment patterns of the respective specimens to those of known HPV controls.
To determine the correlation between the flow fluorescence in situ hybridization method and the PCR assay, the Kappa test was applied, and the reference values adopted were assessed according to the evaluation criteria described by Altman. A Kappa value of 0 implies no agreement, and a value of 1 indicates perfect agreement. Values from 0. Statistical analysis was performed using SPSS The relevant factors were analyzed by the Chi-square test.
The independent variables that were significant for HPV infection from surgical smoke were included in the logistic regression analyses. A 2-tailed P -value of 0. Moreover, HPV DNA in cervical cells, surgical smoke and nasal epithelial cells was detected by using two different methods: flow fluorescence in situ hybridization and a traditional PCR assay.
The HPV genotypes identified in cervical cells by the hybridization technique are presented in Figure 1A. Among the samples, HPV 16, which was the most common type, was detected in The distribution of HPV subtypes in the exfoliated cervical cells was consistent with the HPV genotypes identified in these patients during preoperative examination.
A HPV genotypes identified in exfoliated cervical cells via the flow fluorescence in situ hybridization technique. B HPV genotypes identified in surgical smoke via the flow fluorescence in situ hybridization technique. Six HPV subtypes—HPV16, 18, 31, 33, 52, and 58—were the subtypes most frequently detected by the hybridization technique in our study. As shown in Table 2 , of the cervical cell samples assayed by PCR, 93 In addition, HPV16 was the most common subtype, detected in There were 84 Currently, two major HR-HPV testing methods are used in China: the hybrid capture method and flow fluorescence hybridization, which includes PCR and reverse dot blot hybridization.
However, this test can also produce many false positive results. Additionally, the overall level of agreement was HPV infections detected by flow fluorescence in situ hybridization and a conventional PCR assay in exfoliated cervical cells and surgical smoke. Concordance and agreement for HPV detection by using flow fluorescence in situ hybridization and a PCR assay in exfoliated cervical cells.
Therefore, we concluded that HPV16, 18, 31, 33, 52 and 58 were the 6 most common HPV types that could infect patients with cervical lesions, and HPV16 was determined to be the most prevalent genotype by two different methods. In addition, good concordance between the hybridization technique and PCR assay in terms of HPV detection was further demonstrated. A total of 40 of the surgical smoke samples In the PCR assay, 30 Skip to main content.
Search all BMC articles Search. Download PDF. Aim of the study The aim of this retrospective study was to evaluate the possible correlation existing between the appearance of recurring high-grade lesions and the viral genotype 16, and other risk factors such as residual disease. Materials and methods The study protocol was approved by the Institutional Review Board of the Department and was conducted.
Results The mean age of the patients was Table 1 patients before treatment Full size table. Table 2 Patients after treatment Full size table.
Table 4 Odd Ratio: recurrence after treatment Full size table. Conclusions The prevalence of the diverse genotypes of HPV seen in our cohort is similar to other Italian and European populations [ 14 ]. References 1. Article Google Scholar 2. Article Google Scholar 3.
Article Google Scholar 7. Article Google Scholar 9. Article Google Scholar Acknowledgments We wish to thank the Scientific Bureau of the University of Catania for language support. Funding No funding was involved in the preparation of this research. View author publications. Ethics declarations Ethics approval and consent to participate The study protocol was approved by the Institutional Review Board of the Department and was conducted in accordance with the Declaration of Helsinki.
Consent for publication Not applicable. Competing interests The authors declare that they have no competing interests. About this article. Cite this article Bruno, M. Copy to clipboard. If you plan to conceive after a loop electrosurgical excision procedure LEEP , you might be worried about how it will affect your fertility and pregnancy. Health Home Treatments, Tests and Therapies.
LEEP may also be used to assist in the diagnosis or treatment of the following conditions: Polyps benign growths Genital warts, which may indicate infection with human papilloma virus HPV , a risk factor for developing cervical cancer Diethylstilbestrol DES exposure in women whose mothers took DES during pregnancy, as DES exposure increases the risk for cancer of the reproductive system Your healthcare provider may have other reasons to recommend LEEP.
What are the risks for a LEEP? Some possible complications may include: Infection Bleeding Changes or scarring in the cervix from removal of tissue Trouble getting pregnant Potential for preterm birth or having a low birth weight baby If you are allergic to or sensitive to medications, iodine, or latex, tell your healthcare provider.
If you are pregnant or think you could be, tell your healthcare provider. Certain factors or conditions may interfere with LEEP. Your healthcare provider will explain the procedure and you can ask questions. You will be asked to sign a consent form that gives your permission to do the procedure. Read the form carefully and ask questions if something is not clear.
Generally, no preparation, such as fasting or sedation, is needed. If you are pregnant or think you may be, tell your healthcare provider. Tell your healthcare provider if you are sensitive to or are allergic to any medicines, latex, tape, iodine, and anesthesia. Tell your healthcare provider of all medicines prescribed and over-the-counter and herbal supplements that you are taking. Tell your healthcare provider if you have a history of bleeding disorders or if you are taking any blood-thinning medicines anticoagulants , aspirin, or other medicines that affect blood clotting.
You may be told to stop these medicines before the procedure. Your healthcare provider will tell you not to use tampons, vaginal creams or medicine, douching, or having sex before the procedure. LEEP is usually done when you are not having your menstrual period. What is the likelihood of HPV returning? Is it safe to assume that the virus will not return if the woman and her male partner are monogamous?
Is there a chance that the man still has HPV even if he does not have any signs or symptoms? Although invasive cancer can be diagnosed from the specimen obtained from a LEEP, unless this patient had a radical hysterectomy, radiation, or chemotherapy, I suspect she had CIN rather than invasive cervical cancer.
The prognosis for the patient described is good she has only a 1. Furthermore, compared with the general population, this woman still has an increased risk of being diagnosed with invasive cervical cancer 56 per , vs.
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