HPV L1 and P16 Expression in CIN1 to Predict Future CIN2.

Area of Science:

• Gynecologic Oncology
• Cervical Cancer Biomarkers
• Histopathology

Background:

• Cervical intraepithelial neoplasia grade 1 (CIN1) has variable clinical outcomes, ranging from regression to progression.
• Accurate risk stratification for CIN1 is crucial for appropriate patient management and to avoid overtreatment or undertreatment.

Purpose of the Study:

• To investigate the utility of human papillomavirus (HPV) L1 and p16 biomarkers in developing a triage algorithm for CIN1.
• To identify biomarkers that can predict progression or regression of CIN1 lesions.

Main Methods:

• Retrospective analysis of 82 patients diagnosed with CIN1.
• Immunohistochemical staining for HPV L1 capsid protein and p16 on initial and follow-up tissue samples.
• Clinical follow-up for at least 3 years or until progression to CIN2+.

Main Results:

• p16-positive staining was significantly higher in the CIN1 progression group compared to the regression group.
• The p16-/HPV L1- biomarker pattern was significantly associated with CIN1 regression.
• While p16 expression correlated with progression risk, a sensitive and specific triage algorithm was not achieved.
• Changes in biomarker expression were observed during progression from CIN1 to CIN2+.

Conclusions:

• p16 expression is a significant risk factor for CIN1 progression.
• The p16-/HPV L1- pattern is associated with CIN1 regression.
• Current biomarkers (HPV L1 and p16) are insufficient for a definitive CIN1 triage algorithm.