Page 68 - Strategies for non-invasive managementof high-grade cervical intraepithelial neoplasia - prognostic biomarkers and immunotherapy Margot Maria Koeneman

Chapter 3
Abstract
Objective: Several Human Leucocyte Antigen (HLA) alleles have been associated with a decreased risk of Cervical Intraepithelial Neoplasia (CIN) and its natural prognosis. This study aims to assess HLA-A, -B, -C, -DRB1 and -DQB1 alleles as prognostic biomarkers in high-grade CIN.
Methods: 34 patients with high-grade CIN were selected from a previous prospective population based cohort study, conducted at the Stavanger University Hospital, Norway. Patients were followed for a median of 112 days follow-up, from biopsy to loop excision. HLA-A, -B, -C, -DRB1 and -DQB1 typing was performed in biobank stored blood samples. The influence of HLA alleles on spontaneous regression and HPV16 status of high-grade CIN was assessed by use of contingency tables, using Fisher’s exact test to determine statistical significance (p ≤ 0.05).
Results: HLA typing analysis was successful in 32 patients. 14 patients showed disease regression. No association was found between all studied HLA allele groups and spontaneous regression of high-grade CIN. A significant association was found between HLA-DRB1*13/14 alleles and HPV status: all eight patients with these alleles were HPV16-negative, while HPV16 positive lesions did occur in patients without an HLA-DRB1*13/14 allele.
Conclusion: HLA-DRB1*13/14 may be protective against HPV16-induced high-grade CIN, which indicates an early and HPV16-specific protective effect of an HLA-DRB1*13/14 epitope.
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