Page 57 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman

and other diseases: markers of epigenetic effects are among the most extensively studied at the
moment. No single biomarker or biomarker profile currently offers sufficient prognostic value
in HPV induced lesions, rendering further research for all proposed biomarkers. Obviously, high- 2 grade CIN cannot be left untreated for unlimited follow-up, for obvious ethical reasons. However, spontaneous regression of high-grade CIN has been established and, furthermore, several studies
show that follow-up of untreated high-grade CIN during a mean of 12-16 weeks offers a safe
window for studies evaluating the natural history of these lesions.(6-8) We therefore advocate
further evaluation of the proposed biomarkers in prospective studies, which should be conducted
according to the established (e.g. PROBE) criteria. In the course of the next five years or more, this
could lead to the development of a biomarker profile with high predictive values for the natural
history of high-grade CIN and response to conservative treatment modalities, as a basis for its individualized treatment.
A review of prognostic biomarkers
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