Page 51 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman

A review of prognostic biomarkers
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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
L1 expression
Role in natural behaviour of high- grade CIN seems unlikely: no L1 expression in high- grade CIN
Yes, CIN 1-2-3
2 (65, 68)
Yes, no
65, 279
1. +, +/- 2. +/-, +/- 3.+,+ 4.-,-
L1 negativity was associated with in- creased progression of CIN 1-2 to CIN 3. All CIN 3 cases were L1 negative, reflec- ting complete loss of L1 expression.
Viral load
Increased infectious potential?
Yes, CIN 1-2
1 (69)
No
129
1. +/- 2. +/- 3.+ 4.-
Higher viral loads are associated with increased progres- sion of CIN 1 to CIN 2+. No conclusions on CIN 2.
T-cell epitopes
Specific cell mediated immune response to HPV E6 and E7
Yes, CIN 1-2
2 (71, 72)
Yes
136, 14
1. +, +
2. +/-, +/- 3.+,+ 4.-,-
More disease regression in increased cell mediated immune responses to E7 peptide 105 (aa 37- 54) and E7 peptide (aa 71-85) in HLA- DQB1*02 patients with HPV16+ HSIL.
Viral integration
Cause or result of chromosomal insta- bility: role in natural history unclear
Yes, CIN 1
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