Page 50 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman

Chapter 2
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Biomarker group
Biomarker
Assumed role in natural history of CIN
Studied in histologically confirmed CIN?
No of studies on high-grade CIN (incl CIN 2)
Prospective study design?
Study size (n=)
Evaluation according to the PROBE-criteria*
Effect
Other markers
Cytokine profiles
Indirect marker of immune response types.
Yes, CIN 1-3
1 (51)
Yes
29
1.+ 2. +/- 3. + 4. -
A Th1 cytokine profile (reflecting a stronger cell mediated immune response) in HPV16 positive CIN is associated with increased disease regression.
Viral factors
Viral genotype
HPV16
Increased oncogenic potential.
Yes, CIN 2-3
2 (7, 8)
No, yes
55, 100
1. +/-, + 2. +/-, +/- 3. +, +
4. -, -
HPV16 positive high-grade CIN
is consistently associated with decreased sponta- neous regression.
Viral DNA- methylation
L1 methylation
Altered viral gene expression. Gain of hTERC is correlated with histological disease grade.
Yes, CIN 1-2
1 (64)
No
15
1. +/- 2.- 3. + 4. -
Increased meth- ylation rates were found in the pro- gression group.
Micro-RNA expression
Altered gene expres- sion, has been asso- ciated with cervical carcinogenesis
No No
- -
- -
- -
- -
- -
Host DNA methylation
Altered gene expres- sion, has been iden- tified as a diagnostic marker in CIN.
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