Incidence and mortality from cervical cancer and other malignancies after treatment of cervical intraepithelial neoplasia: a systematic review and meta-analysis of the literature

ObjectiveThe methylation of paired box gene 1 (PAX1) has a great influence on the process of cervical lesion. However, available evidence for the association between PAX1 methylation and cervical intraepithelial neoplasia (CIN) are inconsistent. Here, we systematically reviewed and analyzed PAX1 methylation in progress of CIN.MethodsTwo investigators independently searched eligible studies of PAX1 methylation and CIN that were published in PubMed, Cochrane Library, EMBASE, and Web of Science databases until November 30, 2016. We extracted clinicopathologic features of CIN and cervical cancel relevant to PAX1 methylation. Odds ratios (ORs) with their 95% confidence intervals (CIs) were used to assess the association between PAX1 methylation and progression of patients with CIN.ResultsSeven studies composed of 1055 patients with various stages of CIN and cervical cancel were eventually included. The results revealed that PAX1 methylation was associated with transition of CIN I to CIN II/III (OR, 0.09; 95% CI, 0.04–0.19) and CIN II/III to cervical cancer (OR, 0.16; 95% CI, 0.05–0.46), and similar results were produced in sensitivity analysis. Also, we found that the OR value was associated with average age and number of patients, publication year, and study location of included articles.ConclusionsPAX1 gene methylation was associated with the transition of CIN I to CIN II/III and CIN II/III to cervical cancer, so that it could be an auxiliary biomarker to estimate the risk of CIN progress. Moreover, PAX1 may help to determine appropriate reexaminations and treatment for patients with various stages of CIN.

Download Full-text

P51 The use of human papillomavirus DNA methylation in cervical intraepithelial neoplasia: a systematic review and meta-analysis

10.1136/ijgc-2019-esgo.113 ◽

2019 ◽

Author(s):

S Bowden ◽

I Kalliala ◽

A Veroniki ◽

M Arbyn ◽

A Mitra ◽

...

Keyword(s):

Systematic Review ◽

Dna Methylation ◽

Human Papillomavirus ◽

Cervical Intraepithelial Neoplasia ◽

Meta Analysis ◽

Intraepithelial Neoplasia ◽

Papillomavirus Dna

Download Full-text

Comparative efficacy and complication rates after local treatment for cervical intraepithelial neoplasia and stage 1a1 cervical cancer: protocol for a systematic review and network meta-analysis from the CIRCLE Group

BMJ Open ◽

10.1136/bmjopen-2018-028008 ◽

2019 ◽

Vol 9 (8) ◽

pp. e028008 ◽

Cited By ~ 1

Author(s):

Antonios Athanasiou ◽

Areti Angeliki Veroniki ◽

Orestis Efthimiou ◽

Ilkka Kalliala ◽

Huseyin Naci ◽

...

Keyword(s):

Systematic Review ◽

Cervical Intraepithelial Neoplasia ◽

Primary Outcome ◽

Meta Analysis ◽

Local Treatment ◽

Intraepithelial Neoplasia ◽

Risk Of Bias ◽

Analysis Tool ◽

Complication Rates ◽

Meta Analyses

IntroductionLocal treatments for cervical intraepithelial neoplasia (CIN) and microinvasive disease remove or ablate a cone-shaped part of the uterine cervix containing the abnormal cells. A trend toward less radical techniques has raised concerns that this may adversely impact the rates of precancerous and cancerous recurrence. However, there has been no strong evidence to support such claims. We hereby describe a protocol of a systematic review and network meta-analysis that will update the evidence and compare all relevant treatments in terms of efficacy and complications.Methods and analysisLiterature searches in electronic databases (CENTRAL, MEDLINE, EMBASE) or trial registries will identify published and unpublished randomised controlled trials (RCTs) and cohort studies comparing the efficacy and complications among different excisional and ablative techniques. The excisional techniques include cold knife, laser or Fischer cone, large loop or needle excision of the transformation zone and the ablative radical point diathermy, cryotherapy, cold coagulation or laser ablation. The primary outcome will be residual/recurrent disease defined as abnormal histology or cytology of any grade, while secondary outcomes will include treatment failure rates defined as high-grade histology or cytology, histologically confirmed CIN1+ or histologically confirmed CIN2+, human papillomavirus positivity rates, involved margins rates, bleeding and cervical stenosis rates. We will assess the risk of bias in RCTs and observational studies using tools developed by the Cochrane Collaboration. Two authors will independently assess study eligibility, abstract the data and assess the risk of bias. Random-effects meta-analyses and network meta-analyses will be conducted using the OR for dichotomous outcomes and the mean difference for continuous outcomes. The quality of the evidence for the primary outcome will be assessed using the CINeMA (Confidence In Network Meta-Analysis) tool.Ethics and disseminationEthical approval is not required. We will disseminate findings to clinicians, policy-makers, patients and the public.PROSPERO registration numberCRD42018115508.

Download Full-text