Interaction of epithelial biomarkers, local immune response and condom use in cervical intraepithelial neoplasia 2-3 regression
| Autor: | Einar Gudlaugsson, Bianca van Diermen Hidle, Arnold-Jan Kruse, Jan P. A. Baak, Emiel A. M. Janssen, Ivar Skaland, Irene T Øvestad, Ane Cecilie Munk, Bent Fiane, Kjell Løvslett |
|---|---|
| Přispěvatelé: | Obstetrie & Gynaecologie, RS: GROW - School for Oncology and Reproduction |
| Jazyk: | angličtina |
| Rok vydání: | 2012 |
| Předmět: |
Oncology
Adult medicine.medical_specialty Population Uterine Cervical Neoplasms Cervical intraepithelial neoplasia CIN length law.invention Lesion Cohort Studies Condoms Condom law Internal medicine medicine Humans Prospective Studies Condom use education Papillomaviridae Gynecology education.field_of_study business.industry Obstetrics and Gynecology Cancer medicine.disease Uterine Cervical Dysplasia female genital diseases and pregnancy complications Regression CD4 CD4 Lymphocyte Count pRb Immunohistochemistry Female medicine.symptom business Biomarkers Cohort study |
| Zdroj: | Gynecologic Oncology, 127(3), 489-494. Elsevier Science |
| ISSN: | 0090-8258 |
| DOI: | 10.1016/j.ygyno.2012.09.010 |
| Popis: | 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.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.The regression rate was 21% (34/162). pRb30% in the lower epithelial half was the strongest predictor for regression (30% regression, p0.0001). 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-lesions2.5mm 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%).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. |
| Databáze: | OpenAIRE |
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