OBJECTIVE: Cervical intraepithelial neoplasia grades 2-3 (CIN2-3) are usually treated by cone excision, although only 30% progress to cancer and 6-50% regress spontaneously. Biomarkers predicting CIN2-3 regression would be of great clinical value and could reduce unnecessary cone excision and associated complications. The aim of this study was to investigate whether punch-biopsy derived immunohistochemical biomarkers, local immune response, CIN lesion size and condom use are independently correlated to regression of CIN2-3. METHODS: A prospective population-based cohort study of 162 women aged 25-40, with first-time onset diagnosis of CIN2-3 in colposcopy-directed biopsies was carried out. The median biopsy-cone interval was 16 weeks. Regression was defined as CIN1 or less in the cone biopsy. RESULTS: The regression rate was 21% (34/162). pRb>30% in the lower epithelial half was the strongest predictor for regression (30% regression, p<0.0001). If additionally a CIN-lesion was smaller than 2.5mm and CD4+ lymphoid cells in the subepithelial stroma ≤ 195 per 1.04 mm basal membrane, the regression rate was 53%. In CIN-lesions>2.5mm and CD4+-stroma ≤195, consistent condom use increased the regression rate from 13% to 67% (p=0.003). If pRb was ≤30%, the regression rate was low (6%). CONCLUSION: Biomarkers and CIN lesion length can predict CIN2-3 regression, and might be helpful to identify patients who can increase the regression rate of CIN lesions by consistent condom use.
OBJECTIVE: Cervical intraepithelial neoplasia grades 2-3 (CIN2-3) are usually treated by cone excision, although only 30% progress to cancer and 6-50% regress spontaneously. Biomarkers predicting CIN2-3 regression would be of great clinical value and could reduce unnecessary cone excision and associated complications. The aim of this study was to investigate whether punch-biopsy derived immunohistochemical biomarkers, local immune response, CIN lesion size and condom use are independently correlated to regression of CIN2-3. METHODS: A prospective population-based cohort study of 162 women aged 25-40, with first-time onset diagnosis of CIN2-3 in colposcopy-directed biopsies was carried out. The median biopsy-cone interval was 16 weeks. Regression was defined as CIN1 or less in the cone biopsy. RESULTS: The regression rate was 21% (34/162). pRb>30% in the lower epithelial half was the strongest predictor for regression (30% regression, p<0.0001). If additionally a CIN-lesion was smaller than 2.5mm and CD4+ lymphoid cells in the subepithelial stroma ≤ 195 per 1.04 mm basal membrane, the regression rate was 53%. In CIN-lesions>2.5mm and CD4+-stroma ≤195, consistent condom use increased the regression rate from 13% to 67% (p=0.003). If pRb was ≤30%, the regression rate was low (6%). CONCLUSION: Biomarkers and CIN lesion length can predict CIN2-3 regression, and might be helpful to identify patients who can increase the regression rate of CIN lesions by consistent condom use.
Authors: M M Koeneman; A J Kruse; L F S Kooreman; A Zur Hausen; A H N Hopman; S J S Sep; T Van Gorp; B F M Slangen; H J van Beekhuizen; M van de Sande; C G Gerestein; H W Nijman; R F P M Kruitwagen Journal: BMC Cancer Date: 2016-02-20 Impact factor: 4.430
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Authors: Karoliina Tainio; Antonios Athanasiou; Kari A O Tikkinen; Riikka Aaltonen; Jovita Cárdenas; Sivan Glazer-Livson; Maija Jakobsson; Kirsi Joronen; Mari Kiviharju; Karolina Louvanto; Sanna Oksjoki; Riikka Tähtinen; Seppo Virtanen; Pekka Nieminen; Maria Kyrgiou; Ilkka Kalliala Journal: BMJ Date: 2018-02-27
Authors: Annemiek Leeman; Wieke W Kremer; Marjolein van Zummeren; Maaike C G Bleeker; David Jenkins; Miekel van de Sandt; Daniëlle A M Heideman; Renske Steenbergen; Peter J F Snijders; Wim G V Quint; Johannes Berkhof; Chris J L M Meijer Journal: J Clin Pathol Date: 2018-07-16 Impact factor: 3.411
Authors: Margot M Koeneman; Irene T Ovestad; Emiel A M Janssen; Monique Ummelen; Roy F P M Kruitwagen; Anton H Hopman; Arnold J Kruse Journal: Pathol Oncol Res Date: 2018-10-25 Impact factor: 3.201