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  11. A Prospective Study On The Progression, Recurrence, And Regression Of Cervical Lesions: Assessing Various Screening Approaches

A Prospective Study on the Progression, Recurrence, and Regression of Cervical Lesions: Assessing Various Screening Approaches

Tudor Gisca1, Iulian-Valentin Munteanu2, Ingrid-Andrada Vasilache1

  • 1Department of Mother and Child Care, "Grigore T. Popa" University of Medicine and Pharmacy Iasi, 700115 Iasi, Romania.

Journal of Clinical Medicine
|April 9, 2024

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Four-color Fluorescence Immunohistochemistry of T-cell Subpopulations in Archival Formalin-fixed, Paraffin-embedded Human Oropharyngeal Squamous Cell Carcinoma Samples
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View abstract on PubMed

Summary
This summary is machine-generated.

Predicting cervical lesion progression in HPV-positive patients is crucial. A combination of Pap smear, HPV genotyping, p16/Ki67 staining, and risk factors accurately predicts progression, but regression and persistence prediction require further improvement.

Area of Science:

  • Gynecology
  • Oncology
  • Virology

Background:

  • Cervical lesion evolution prediction poses a clinical challenge.
  • Human papillomavirus (HPV) infection is a primary cause of cervical lesions.
  • Accurate prediction of lesion behavior is vital for patient management.

Purpose of the Study:

  • To compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining.
  • To evaluate the combined predictive performance of these tests with clinical risk factors.
  • To predict the progression, regression, or persistence of cervical lesions in HPV-infected patients.

Main Methods:

  • Prospective study of HPV-positive patients with or without cervical lesions.
  • Evaluation of individual and combined predictive performance of cervical cytology, HPV genotyping, p16/Ki67 dual staining (CINtecPlus), and clinical risk factors.
Keywords:
HPV genotypingcervical cytologycervical lesionsclinical risk factors

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  • Statistical analysis including sensitivity, specificity, and AUC for prediction of lesion outcomes.

    • Main Results:

    • A model combining HSIL Pap smear, HPV 16/18, positive p16/Ki67, and ≥3 risk factors showed high predictive performance for progression (Se 74.42%, Sp 97.92%, AUC 0.961, accuracy 90.65%).
    • Individual or combined tests demonstrated modest predictive performance for cervical lesion regression or persistence.
    • The combination of multiple biomarkers and risk factors is effective for predicting cervical lesion progression.

    Conclusions:

    • Current methods show high accuracy in predicting cervical lesion progression.
    • Improved surveillance strategies, potentially involving multiple tests or novel biomarkers, are needed for better prediction of lesion regression or persistence.
    • Further research is warranted to enhance the prediction of cervical lesion regression and persistence in HPV-positive individuals.
    p16/Ki67 dual staining