Precancerous cervical lesions and immunomarkers for their prognosis


Precancerous cervical lesions and immunomarkers for their prognosis

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Title: Precancerous cervical lesions and immunomarkers for their prognosis
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Article_Title: Precancerous cervical lesions and immunomarkers for their prognosis
Authors: Diana Mocuta*1, Tiberiu Pop1, Florin Szasz1, Elena Lazar2
Affiliation: 1 University of Oradea, Faculty of Medicine and Pharmacy, Obstetrics- Gynecology Department, Romania
2 University of Medicine and Pharmacy “Victor Babeş” Timişoara, Morphopatology Department, Romania
Abstract: Cervical cancer is a disease which still affects too many women, even if we live in the XXIst century. Pap smear represented for few decades an important tool in the diagnosis of this pathology and is consider the most important screening method with a good acceptance from the patients. We know the importance of human papilloma virus (HPV) infection in cervical malignant pathology and its evolution. The diagnosis of presence of HPV-high risk type can give a prognosis for precancerous lesions. These lesions appear with months or years before malignant affections of the cervix and if we put the diagnosis of an increased cell proliferation, or we demonstrate the infection with HPV-HR, we can use this time to monitories or give the appropriate treatment for the precancerous lesions. There are immunomarkers for these kind of investigations and from them, we used Ki-67 and p53, trying to demonstrate the usefulness of immunochemical markers in the diagnosis and prognosis of cervical precancerous lesions.
Keywords: cervical precancer, HPV, p53, Ki-67, immunomarkers
References: Hannah H. Alphs, T-C Wu, Richard B.S.Roden. Prevention and Treatment of Cervical Cancer by Vaccination. Molecular Pathology of Gynecology Cancer, 2007 Humana Press, Totowa, New Jersey, 124- 154
Ardeleanu Carmen, Vasilescu Florina, Lungu Mona. HPV infection of uterine cervix. Uterine precancer and cancer. Publishing Eurobit, Timisoara, 2007;116 – 126.
Bahnassy AA, Zekri AR, Saleh M, et al. The possible role of cell cycle regulators in multistep process of HPV-associated cervical carcinoma. BMC Clinical Patholoy, 2007;7:4. doi:10.1186/1472-6890-7-4.
Brown FM, Faquin WC, Sun D, Crum CP, Cibas ES. LSIL biopsies after HSIL smears. Correlation with high-risk HPV and greater risk of HSIL on follow-up. American Journal of Clinic Pathology 1999; 112(6): 765–768.
Carmen Constantinescu, C. Văduva, Alice Văduva, Alexandra Buzatu. HPV oncoproteins and genomic instability. Gineco.ro, 2007;3(2)
Cox JT, Schiffman M, Solomon D. ASCUS-LSIL Triage Study (ALTS) Group. Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia grade 1 or negative colposcopy and directed biopsy. American Journal Obstetetrics Gynecology 2003; 188(6): 1406–1412
Ferenczy A, Franco E. Persistent human papillomavirus infection and cervical neoplasia. Lancet Oncology 2002;3(1): 11-16.
Grace VM, Shalini JV, Iekha TT, SN Devaraj, H. Devaraj Co-overexpression of p53 and bcl-2 proteins in HPV-induced squamous cell carcinoma of the uterine cervix. Gynecologic Oncology, October 2003, 91(1): 51-8.
Hildesheim A, Schiffman MH, Gravitt PE et al. Persistence of type-specific human papillomavirus infection among cytologically normal women. Journal of Infections Disease 1994;169(2): 235-240.
Hiller T. Poppelreuther S, Stubenrauch F, Iftner T. Comparative analisys of genital human papillomavirus types with regard to p53 degradation, immortalization. Phylogeny and epidemiological risk classification. Cancer Epidemiology Biomarkers Preview. July 2006, 15(7): 1262-1267.
Ho GY, Studentsov YY, Bierman R, Burk RD. Natural history of human papillomavirus type 16 virus-like particle antibodies in young women. Cancer Epidemiology, Biomarkers & Prevention 2004; 13(1):110-116.
Kaufmann WK, Schwartz JL, Hurt JC, et al. Inactivation of G2 checkpoint function and chromosomal destabilization are linked in human fibroblasts expressing human papillomavirus type 16 E6. Cell Growth and Differention 1997; 8: 1105-1114.
Koutsky LA, Holmes KK, Critchlow CW, et al. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. NEJM 1992; 327: 1272-1278.
Kruse AJ, Baak JP, de Bruin PC, et al. Ki-67 immunoquantitation in cervical intraepithelial neoplasia (CIN): a sensitive marker for grading. Journal of Pathology 2001; 193: 48- 54
Kruse AJ, Baak JP, Jansen EA, et al. Low and high – risk CIN 1 and 2 lesions: prospective predictive value of grade, HPV and Ki-67 immuno-quantitative variables. Journal of Pathology 2003; 199: 462-70.
Deepak Kumar, Ph.D., Mukesh Verma, Ph.D. Molecular markers of cervical squamous cell carcinoma. CME Journal of Gynecologic Oncology 2006; 11:41-60.
Lazăr Elena, Păuna Claudia, Panţu Alexandra. HPV infection of uterine cervix. Uterine precancer and cancer. Publishing Eurobit, Timisoara, 2007;173 -208.
Lee SS, Collins RJ, Pun TC, Cheng DK, Ngan HY. Conservative treatment of low grade squamous intraepithelial lesions (LSIL) of the cervix. International Journal Gynecology Obstetrics 1998; 60 (1):35-40.
Valeria Masciullo, Antonio Giordano. Molecular Genetics of Cervical Cancer. Molecular Pathology of Gynecology Cancer, 2007, Humana Press, Totowa, New Jersey: 113-123..
Anna-Barbara Moscicki. Natural History of HPV Infection in Adolescents and Relationship to Cervical Cancer. Molecular Pathology of Gynecology Cancer, 2007, Humana Press,Totowa, New Jersey: 103-111;
Moscicki AB, Hills N, Shiboski S, et al. Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA 2001;285(23):2995-3002.
Moscicki AB, Shiboski S, Broering KJ et al. The natural history of human infection as measured by repeated DNA testing in adolescent and young women. Journal of Pediatrics 1998;132:277-284.
Moscicki AB, Shiboski S, Hills NK, et al. Regresion of low-grade squamous intraepithelial lesions in young women. Lancet 2004; 364 (9446):1678-1683.
Nash JD, Burke TW, Hoskins WJ. Biologic course of cervical human papillomavirus infection. Obstetrics Gynecology 1987; 69: 160-162.
Nassiel K, Nassiel M, Vaclavinkova V. Behavior of Moderate Cervical Dysplasia During Long Term Follow-up. Obstetrics Gynecology 1983; 61: 609-614.
Qiao X, Bhuiya TA, Spitzer M. Differentiating highgrade cervical intraepithelial lesion from atrophy in postmenopausal women using Ki-67, cyclin E and p16 immunohistochemical analysis. Journal of Low Genital Tract Disease, 2005;9:100-107.
S.Sahebali, C.E. Depuydt, K. Segers, A.J. Vereecken, E. Van Marck, J.J. Bogers. Ki-67 immunocytochemistry in liquid based cervical cytology: useful as an adjunctive tool? Journal of Clinical Pathology, Sept.2003; 56(9): 681-686.
Sarian LO, Derchain SF, Yoshida A, et al. Expression of cyclooxygenase-2 (COX-2) and Ki67 as related to disease severity and HPV detection in squamous lesions of the cervix. Gynecological Oncology,2006;102:537-541.
Scheffner M, Huibregtse JM, Viestra RD, Howley PM. The HPV-16 E6 and E6-AP complex functions as ubiquitin-protein ligase in the ubiquitination of p53. Cell 1993; 75: 495-505.
Schlecht NF, Platt RW, Duarte-Franco E, et al. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. Journal of the National Cancer Institute 2003; 95(17): 1336-1343.
Syrjanen K, Kataja V, Yliskoski, Chang F, Syrjanen S. Natural History of Cervical Human Papillomavirus lesions Does Not Substantiate the Biologic Relevance of the Bethesda System. Obstetrics Gynecology 1992;79:675-682.
Thomas M, Pim D, Banks L. The role of the E6-p53 interaction in the molecular pathogenesis of HPV. Oncogene 1999;18:7690-7700.
Tsuda H, Hashiguchi Y, Nishimura S et al. Relationship between HPV typing and abnormality of G1 cell cycle regulators in cervical neoplasm. Gynecological Oncology,2003;91:476-485.
Nicolas Wentzensen, MD, Svetlana Vinokurova, PhD, Magnus Von Knebel Doeberitz, MD. Molecular markers of cervical squamous cell carcinoma recursors lesions. CME Journal of Gynecologic Oncology 2006; 11: 30-40.
Wright JD, Davila RM, Pinto KR, et al. Cervical dysplasia in adolescents. Obstetrics Gynecology 2005; 106(1):115-120.
Read_full_article: pdf/20-2010/20-2-2010/SU20-2-10Mocuta.pdf
Correspondence: Diana Mocuta, Clinical Hospital of Obstetrics-Gynecology, 50-52 Clujului st, Oradea 410053, Romania, email: dianam07@yahoo.com

Read full article
Article Title: Precancerous cervical lesions and immunomarkers for their prognosis
Authors: Diana Mocuta*1, Tiberiu Pop1, Florin Szasz1, Elena Lazar2
Affiliation: 1 University of Oradea, Faculty of Medicine and Pharmacy, Obstetrics- Gynecology Department, Romania
2 University of Medicine and Pharmacy “Victor Babeş” Timişoara, Morphopatology Department, Romania
Abstract: Cervical cancer is a disease which still affects too many women, even if we live in the XXIst century. Pap smear represented for few decades an important tool in the diagnosis of this pathology and is consider the most important screening method with a good acceptance from the patients. We know the importance of human papilloma virus (HPV) infection in cervical malignant pathology and its evolution. The diagnosis of presence of HPV-high risk type can give a prognosis for precancerous lesions. These lesions appear with months or years before malignant affections of the cervix and if we put the diagnosis of an increased cell proliferation, or we demonstrate the infection with HPV-HR, we can use this time to monitories or give the appropriate treatment for the precancerous lesions. There are immunomarkers for these kind of investigations and from them, we used Ki-67 and p53, trying to demonstrate the usefulness of immunochemical markers in the diagnosis and prognosis of cervical precancerous lesions.
Keywords: cervical precancer, HPV, p53, Ki-67, immunomarkers
References: Hannah H. Alphs, T-C Wu, Richard B.S.Roden. Prevention and Treatment of Cervical Cancer by Vaccination. Molecular Pathology of Gynecology Cancer, 2007 Humana Press, Totowa, New Jersey, 124- 154
Ardeleanu Carmen, Vasilescu Florina, Lungu Mona. HPV infection of uterine cervix. Uterine precancer and cancer. Publishing Eurobit, Timisoara, 2007;116 – 126.
Bahnassy AA, Zekri AR, Saleh M, et al. The possible role of cell cycle regulators in multistep process of HPV-associated cervical carcinoma. BMC Clinical Patholoy, 2007;7:4. doi:10.1186/1472-6890-7-4.
Brown FM, Faquin WC, Sun D, Crum CP, Cibas ES. LSIL biopsies after HSIL smears. Correlation with high-risk HPV and greater risk of HSIL on follow-up. American Journal of Clinic Pathology 1999; 112(6): 765–768.
Carmen Constantinescu, C. Văduva, Alice Văduva, Alexandra Buzatu. HPV oncoproteins and genomic instability. Gineco.ro, 2007;3(2)
Cox JT, Schiffman M, Solomon D. ASCUS-LSIL Triage Study (ALTS) Group. Prospective follow-up suggests similar risk of subsequent cervical intraepithelial neoplasia grade 2 or 3 among women with cervical intraepithelial neoplasia grade 1 or negative colposcopy and directed biopsy. American Journal Obstetetrics Gynecology 2003; 188(6): 1406–1412
Ferenczy A, Franco E. Persistent human papillomavirus infection and cervical neoplasia. Lancet Oncology 2002;3(1): 11-16.
Grace VM, Shalini JV, Iekha TT, SN Devaraj, H. Devaraj Co-overexpression of p53 and bcl-2 proteins in HPV-induced squamous cell carcinoma of the uterine cervix. Gynecologic Oncology, October 2003, 91(1): 51-8.
Hildesheim A, Schiffman MH, Gravitt PE et al. Persistence of type-specific human papillomavirus infection among cytologically normal women. Journal of Infections Disease 1994;169(2): 235-240.
Hiller T. Poppelreuther S, Stubenrauch F, Iftner T. Comparative analisys of genital human papillomavirus types with regard to p53 degradation, immortalization. Phylogeny and epidemiological risk classification. Cancer Epidemiology Biomarkers Preview. July 2006, 15(7): 1262-1267.
Ho GY, Studentsov YY, Bierman R, Burk RD. Natural history of human papillomavirus type 16 virus-like particle antibodies in young women. Cancer Epidemiology, Biomarkers & Prevention 2004; 13(1):110-116.
Kaufmann WK, Schwartz JL, Hurt JC, et al. Inactivation of G2 checkpoint function and chromosomal destabilization are linked in human fibroblasts expressing human papillomavirus type 16 E6. Cell Growth and Differention 1997; 8: 1105-1114.
Koutsky LA, Holmes KK, Critchlow CW, et al. A cohort study of the risk of cervical intraepithelial neoplasia grade 2 or 3 in relation to papillomavirus infection. NEJM 1992; 327: 1272-1278.
Kruse AJ, Baak JP, de Bruin PC, et al. Ki-67 immunoquantitation in cervical intraepithelial neoplasia (CIN): a sensitive marker for grading. Journal of Pathology 2001; 193: 48- 54
Kruse AJ, Baak JP, Jansen EA, et al. Low and high – risk CIN 1 and 2 lesions: prospective predictive value of grade, HPV and Ki-67 immuno-quantitative variables. Journal of Pathology 2003; 199: 462-70.
Deepak Kumar, Ph.D., Mukesh Verma, Ph.D. Molecular markers of cervical squamous cell carcinoma. CME Journal of Gynecologic Oncology 2006; 11:41-60.
Lazăr Elena, Păuna Claudia, Panţu Alexandra. HPV infection of uterine cervix. Uterine precancer and cancer. Publishing Eurobit, Timisoara, 2007;173 -208.
Lee SS, Collins RJ, Pun TC, Cheng DK, Ngan HY. Conservative treatment of low grade squamous intraepithelial lesions (LSIL) of the cervix. International Journal Gynecology Obstetrics 1998; 60 (1):35-40.
Valeria Masciullo, Antonio Giordano. Molecular Genetics of Cervical Cancer. Molecular Pathology of Gynecology Cancer, 2007, Humana Press, Totowa, New Jersey: 113-123..
Anna-Barbara Moscicki. Natural History of HPV Infection in Adolescents and Relationship to Cervical Cancer. Molecular Pathology of Gynecology Cancer, 2007, Humana Press,Totowa, New Jersey: 103-111;
Moscicki AB, Hills N, Shiboski S, et al. Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females. JAMA 2001;285(23):2995-3002.
Moscicki AB, Shiboski S, Broering KJ et al. The natural history of human infection as measured by repeated DNA testing in adolescent and young women. Journal of Pediatrics 1998;132:277-284.
Moscicki AB, Shiboski S, Hills NK, et al. Regresion of low-grade squamous intraepithelial lesions in young women. Lancet 2004; 364 (9446):1678-1683.
Nash JD, Burke TW, Hoskins WJ. Biologic course of cervical human papillomavirus infection. Obstetrics Gynecology 1987; 69: 160-162.
Nassiel K, Nassiel M, Vaclavinkova V. Behavior of Moderate Cervical Dysplasia During Long Term Follow-up. Obstetrics Gynecology 1983; 61: 609-614.
Qiao X, Bhuiya TA, Spitzer M. Differentiating highgrade cervical intraepithelial lesion from atrophy in postmenopausal women using Ki-67, cyclin E and p16 immunohistochemical analysis. Journal of Low Genital Tract Disease, 2005;9:100-107.
S.Sahebali, C.E. Depuydt, K. Segers, A.J. Vereecken, E. Van Marck, J.J. Bogers. Ki-67 immunocytochemistry in liquid based cervical cytology: useful as an adjunctive tool? Journal of Clinical Pathology, Sept.2003; 56(9): 681-686.
Sarian LO, Derchain SF, Yoshida A, et al. Expression of cyclooxygenase-2 (COX-2) and Ki67 as related to disease severity and HPV detection in squamous lesions of the cervix. Gynecological Oncology,2006;102:537-541.
Scheffner M, Huibregtse JM, Viestra RD, Howley PM. The HPV-16 E6 and E6-AP complex functions as ubiquitin-protein ligase in the ubiquitination of p53. Cell 1993; 75: 495-505.
Schlecht NF, Platt RW, Duarte-Franco E, et al. Human papillomavirus infection and time to progression and regression of cervical intraepithelial neoplasia. Journal of the National Cancer Institute 2003; 95(17): 1336-1343.
Syrjanen K, Kataja V, Yliskoski, Chang F, Syrjanen S. Natural History of Cervical Human Papillomavirus lesions Does Not Substantiate the Biologic Relevance of the Bethesda System. Obstetrics Gynecology 1992;79:675-682.
Thomas M, Pim D, Banks L. The role of the E6-p53 interaction in the molecular pathogenesis of HPV. Oncogene 1999;18:7690-7700.
Tsuda H, Hashiguchi Y, Nishimura S et al. Relationship between HPV typing and abnormality of G1 cell cycle regulators in cervical neoplasm. Gynecological Oncology,2003;91:476-485.
Nicolas Wentzensen, MD, Svetlana Vinokurova, PhD, Magnus Von Knebel Doeberitz, MD. Molecular markers of cervical squamous cell carcinoma recursors lesions. CME Journal of Gynecologic Oncology 2006; 11: 30-40.
Wright JD, Davila RM, Pinto KR, et al. Cervical dysplasia in adolescents. Obstetrics Gynecology 2005; 106(1):115-120.
*Correspondence: Diana Mocuta, Clinical Hospital of Obstetrics-Gynecology, 50-52 Clujului st, Oradea 410053, Romania, email: dianam07@yahoo.com