Biomarkers differentiating regression from progression among untreated cervical intraepithelial neoplasia grade 2 lesions

Xiang Li ¹, Yan Chen ², Jing Xiong ³

¹Department of Gynecology, The Third Xiangya Hospital, Central South University, 138 Tong Zipo Road, Changsha 410013, P. R. China.
²Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, P. R. China; Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha 410078, P. R. China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, P. R. China; National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, Hunan, P. R. China; Xiangya Medical Laboratory, Central South University, 110 Xiangya Road, Changsha 410078, P. R. China.
³Department of Gynecology and Obstetrics, The Second Xiangya Hospital, Central South University, 139 Renmin Road, Changsha 410011, P. R. China.
⁴Department of Gynecology, The Maternal and Child Health Hospital of Zibo City, Zibo City, Shandong 255029, P. R. China.
⁵Department of Clinical Pharmacology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha 410008, P. R. China; Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, 110 Xiangya Road, Changsha 410078, P. R. China; Engineering Research Center of Applied Technology of Pharmacogenomics, Ministry of Education, 110 Xiangya Road, Changsha 410078, P. R. China; National Clinical Research Center for Geriatric Disorders, 87 Xiangya Road, Changsha 410008, Hunan, P. R. China.

⁰Department of Gynecology, The Third Xiangya Hospital, Central South University, 138 Tong Zipo Road, Changsha 410013, P. R. China.

Journal of Advanced Research +

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September 11, 2024

View abstract on PubMed

Summary

Identifying biomarkers for cervical intraepithelial neoplasia grade 2 (CIN2) regression is crucial for personalized treatment. This review explores HPV, host genetics, and microenvironment factors to predict CIN2 outcomes, aiming to reduce over-treatment.

Area Of Science

Gynecologic oncology
Molecular pathology
Infectious disease

Background

Cervical intraepithelial neoplasia grade 2 (CIN2) has an unpredictable natural history, with lesions potentially progressing to cancer, regressing, or persisting.
Current management often involves surgical treatment for most CIN2 cases, leading to potential over-treatment and complications, especially for fertility-sparing management.
Identifying biomarkers for CIN2 regression is essential for individualized treatment strategies.

Purpose Of The Study

To review and summarize biomarkers that predict the spontaneous regression of CIN2 lesions.
To explore factors influencing CIN2 natural history, including human papillomavirus (HPV) and host-related elements.
To highlight the need for further validation of potential biomarkers in prospective studies.

Main Methods

Literature review of studies on biomarkers for CIN2 regression.
Analysis of factors such as HPV genotype, HPV methylation, p16/Ki-67 status, host gene methylation, HLA subtypes, immune microenvironment, and vaginal microbiota.
Synthesis of current knowledge on predictive markers for CIN2 outcomes.

Main Results

Biomarkers associated with CIN2 regression include HPV infection characteristics, host gene (epi)genetic changes, and alterations in the tumor microenvironment.
The interplay of viral, host, and microenvironmental factors influences the clinical course of CIN2.
No single biomarker is currently sufficient; a combination of factors may be necessary.

Conclusions

Biomarkers correlating with HPV infection, host gene (epi)genetic changes, and microenvironment shifts can predict CIN2 regression.
Prospective cohort studies with larger enrollment, longer follow-up, and comprehensive patient tracking are required for biomarker validation.
Accurate prediction of CIN2 behavior can guide personalized treatment, avoiding unnecessary interventions and complications.

Keywords:

Cervical intraepithelial lesion Human papillomavirus Methylation Progression Regression

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