High-Risk Human Papillomavirus Load and Biomarkers in Cervical Intraepithelial Neoplasia and Cervical Cancer
Mee Soo Chang, Sohee Oh, Eun-Jung Jeong, Jeong Hwan Park, Jung Ho Kim, In-Ae Park. Seoul National University Boramae Hospital, Seoul, Korea; Seoul National University College of Medicine, Seoul, Korea
Background: To elucidate the clinical significance of high-risk human papillomavirus (HPV) DNA load in predicting the presence and grade of uterine cervical intraepithelial neoplasia (CIN) and cervical cancer, and to investigate biomarkers for HPV-related oncogenesis.
Design: HPV DNA load test was performed in 343 women, liquid-based cervical cytology in 339 women, and colposcopic biopsy and immunohistochemistry for p16INK4A (p16), cyclin D1, p53, cyclooxygenase-2 (COX-2) and Ki-67 in 143 women.
Results: HPV DNA load, log10-transformed HPV DNA load and HPV infection status were correlated with the cytological and histological severity of cervical disease (P < 0.05, respectively). Moreover, even in negative cytology group or 'atypical squamous cells of undetermined significance (ASCUS)' cytology group, the histological severity of cervical disease was associated with HPV DNA load, log10-transformed HPV DNA load and HPV infection status (P< 0.05, respectively). Besides, in the 'ASCUS' cytology group, 2.385 pg/ml of HPV DNA load appeared to be the cutoff value at which 'histological negative' or CIN I can be differentiated from 'histological high-grade' cervical diseases (AUC = 0.712, specificity = 0.721, sensitivity = 0.800), but not statistically significant (P = 0.125). The histological severity of cervical disease was positively associated with p16, COX-2, Ki-67 expression and HPV infection, but was negatively correlated with cyclin D1 expression (P < 0.05, respectively).
Conclusions: HPV DNA loads can be auxiliary data in predicting the presence and severity of CIN. However, in the ASCUS group, there is no absolute cutoff value of HPV load by which 'histological high-grade' cervical diseases can be predictable, although 2.385 pg/ml seems to be a tempting cutoff. The p16, COX-2 and Ki-67 proteins may be involved in HPV-associated cervical oncogenesis.
Category: Gynecologic & Obstetrics
Tuesday, March 5, 2013 1:00 PM
Poster Session IV # 226, Tuesday Afternoon