Alterations in human papillomavirus-related biomarkers after treatment of cervical intraepithelial neoplasia
Φόρτωση...
Ημερομηνία
Συγγραφείς
Valasoulis, G.
Koliopoulos, G.
Founta, C.
Kyrgiou, M.
Tsoumpou, I.
Valari, O.
Martin-Hirsch, P.
Daponte, A.
Karakitsos, P.
Paraskevaidis, E.
Τίτλος Εφημερίδας
Περιοδικό ISSN
Τίτλος τόμου
Εκδότης
Περίληψη
Τύπος
Είδος δημοσίευσης σε συνέδριο
Είδος περιοδικού
peer-reviewed
Είδος εκπαιδευτικού υλικού
Όνομα συνεδρίου
Όνομα περιοδικού
Gynecol Oncol
Όνομα βιβλίου
Σειρά βιβλίου
Έκδοση βιβλίου
Συμπληρωματικός/δευτερεύων τίτλος
Περιγραφή
OBJECTIVE: This study aims to assess the alterations in various HPV-related biomarkers 6 months post-treatment and how these relate to various risk factors and individual characteristics; their role for the prediction of treatment failure was also evaluated. MATERIAL AND METHODS: Design: Prospective observational study. Population: Women planning to undergo treatment for cervical intraepithelial neoplasia. Intervention: A liquid-based cytology sample was taken pre-operatively. This was tested for HPV genotyping, Nucleic Acid Sequence Based Amplification, flow cytometric evaluation and p16 immunostaining. A repeat LBC sample was obtained 6 months post-treatment and was tested for the same biomarkers. Outcomes: The alterations of the biomarkers 6 months post-treatment were recorded. Their relation to individual characteristics and risk factors (age, smoking, sexual history, use of condom, CIN grade, excision margin status, crypt involvement) as well as their role for the prediction of residual/recurrent disease were assessed. Analysis: The accuracy parameters (sensitivity, specificity, positive and negative predictive value and the likelihood ratios) of each biomarker for the prediction of recurrent/residual CIN were calculated. RESULTS: A total of 190 women were recruited. All biomarkers had significantly higher negativity rates post-treatment compared to pre-treatment ones. Multivariate analysis demonstrated that consistent condom use post-treatment significantly reduces the high-risk HPV positivity rates in comparison to no use (OR=0.18; 95% CI: 0.09-0.38). Sensitivity and specificity for all high risk HPV DNA testing were 0.5/0.62, respectively; the relevant values for only type 16 or 18 DNA typing were 0.5/0.92, for NASBA 0.5/0.94, for flow 0.5/0.85 and for p16 0.25/0.93. CONCLUSION: CIN treatment reduces positivity for all HPV-related biomarkers. Consistent condom use significantly reduces high-risk HPV positivity rates. More cases of treatment failures are required in order to specify whether different combinations of HPV-related biomarkers could enhance the accuracy of follow up, possibly in the form of a Scoring System that could allow tailored post-treatment surveillance.
Περιγραφή
Λέξεις-κλειδιά
Adult, Cervical Intraepithelial Neoplasia/metabolism/pathology/*surgery/*virology, Electrosurgery, Female, Flow Cytometry, Genotype, Humans, Middle Aged, Neoplasm Recurrence, Local/metabolism/pathology/virology, Papillomaviridae/genetics/*metabolism, Papillomavirus Infections/*metabolism/pathology/virology, Predictive Value of Tests, Tumor Markers, Biological/*metabolism, Uterine Cervical Neoplasms/metabolism/pathology/*surgery/*virology, Young Adult
Θεματική κατηγορία
Παραπομπή
Σύνδεσμος
http://www.ncbi.nlm.nih.gov/pubmed/21216451
http://ac.els-cdn.com/S0090825810008851/1-s2.0-S0090825810008851-main.pdf?_tid=edac4bfd2f871829f932212ffc83d32e&acdnat=1333713980_6b00b2774ccb3e690e78cd9285120208
http://ac.els-cdn.com/S0090825810008851/1-s2.0-S0090825810008851-main.pdf?_tid=edac4bfd2f871829f932212ffc83d32e&acdnat=1333713980_6b00b2774ccb3e690e78cd9285120208
Γλώσσα
en
Εκδίδον τμήμα/τομέας
Όνομα επιβλέποντος
Εξεταστική επιτροπή
Γενική Περιγραφή / Σχόλια
Ίδρυμα και Σχολή/Τμήμα του υποβάλλοντος
Πανεπιστήμιο Ιωαννίνων. Σχολή Επιστημών Υγείας. Τμήμα Ιατρικής