Changes in the genetic landscape during the malignization of high grade squamous intraepithelial lesion into cervical cancer

CONTEXT AND OBJECTIVE: Cervical cancer is a serious public health problem in Brazil. For patients with unsatisfactory colposcopic examinations without visible lesions, but with cervical cytological tests suggesting high-grade squamous intraepithelial lesion (HSIL), the national recommendation is to repeat cervical cytological tests after three months. Our aim was to assess the prevalence of HSIL and cancer among patients with initial cervical cytological tests suggestive of HSIL but with unsatisfactory colposcopic examinations without visible lesions, in order to contribute towards the discussion regarding a more effective clinical approach that might diminish the likelihood of patient abandonment of follow-up before appropriate diagnosis and treatment. DESIGN AND SETTING: Cross-sectional study in Colposcopy Clinic of IFF/Fiocruz. METHOD: Patients admitted between December 1989 and April 2007 with cytological diagnoses of HSIL but with unsatisfactory colposcopic examinations without visible lesions underwent cervical cone biopsy. RESULTS: Sixty-five such patients were included, comprising 33.8% with HSIL and 4.6% with cancer, confirmed histologically. The other patients presented low-grade squamous intraepithelial lesion (26.1%), glandular dysplasia (1.5%) and absence of disease (33.8%). CONCLUSION: The observed prevalence of cancer and HSIL does not seem to be enough to justify immediate referral for cone biopsies to investigate the cervical canal in these cases. The findings suggest that the recommendation of repeated cytological tests following an initial one with HSIL, among patients with unsatisfactory colposcopic examinations without visible lesions, is appropriate in our setting. Efforts are needed to ensure adherence to follow-up protocols in order to reduce the chances of losses.

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Prevalence and distribution of human papillomavirus genotypes among women with high‐grade squamous intraepithelial lesion and invasive cervical cancer in Ganzhou, China

Journal of Clinical Laboratory Analysis ◽

10.1002/jcla.22708 ◽

2018 ◽

Vol 33 (3) ◽

pp. e22708 ◽

Cited By ~ 3

Author(s):

Linhong Liao ◽

Hui Cheng ◽

Fansheng Zeng ◽

Weijie Zhou ◽

Yanqing Ding

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Invasive Cervical Cancer ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion

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Research of the Potential Vaginal Microbiome Biomarkers for High-Grade Squamous Intraepithelial Lesion

Frontiers in Medicine ◽

10.3389/fmed.2021.565001 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xiaopei Chao ◽

Lan Wang ◽

Shu Wang ◽

Jinghe Lang ◽

Xianjie Tan ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

High Risk ◽

Relative Abundance ◽

Hpv Infection ◽

High Grade ◽

Vaginal Microbiome ◽

Squamous Intraepithelial Lesion ◽

Cervical Neoplasm ◽

Intraepithelial Lesion

Vaginal microbiome may have a role in HPV infection and cervical neoplasm. To explore potential vaginal microbiome biomarkers for high-grade squamous intraepithelial lesion (HSIL), and to find the best scheme to facilitate the current cervical cancer screening strategy. This study enrolled 272 women, including 83 confirmed with HSIL, 86 with HPV infection but without cervical neoplasm, and 103 without HPV infection as controls. Vaginal microbiome composition was determined by sequencing of barcoded 16S rDNA gene fragments (V4) on Illumina HiSeq2500. The relative increasing abundance of Stenotrophomonas, Streptococcus, and Pseudomonas, and a concomitant paucity of Dialister, unidentified Prevotellaceae, Faecalibacterium, Bifidobacterium, and Bacteroides, were related with HSIL, which can be used to predict the development of HISL in high-risk HPV infected patients. The relative abundance of Stenotrophomonas being over 0.0090387%, or Faecalibacterium being under 0.01420015%, or Bifidobacterium being under 0.0116183% maybe a good predictor for HSIL for those infected with HPV 16 and/or 18. The relative abundance of Stenotrophomonas being over 0.01549105%, or Streptococcus being over 0.48409585%, or Bacteroides being under 0.0296912% maybe a good predictor for HSIL for those infected with the 12 other high-risk types of HPV with concurrent abnormal TCT results. This study revealed that potential vaginal microbiome biomarkers may relate to HSIL, and can facilitate the cervical cancer screening.

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Diagnostic value of VIA comparing with conventional pap smear in the detection of colposcopic biopsy proved CIN

Health Renaissance ◽

10.3126/hren.v9i3.5579 ◽

1970 ◽

Vol 9 (3) ◽

pp. 134-139

Author(s):

D Hegde ◽

H Shetty ◽

PK Shetty ◽

S Rai ◽

L Manjeera ◽

...

Keyword(s):

Cervical Cancer ◽

Acetic Acid ◽

Predictive Value ◽

Visual Inspection ◽

Pap Smear ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Low Resource Settings ◽

Low Resource ◽

Intraepithelial Lesion

Introduction: Cervical cancer, the leading malignancy among Indian women is preventable and curable if detected at an early stage using proper screening tools. We conducted a study to assess the role of visual inspection with acetic acid as an alternative to pap smear and in screening program for cervical cancer in low resource settings. Methods: Two hundred and twenty five women in reproductive age group attending the Gynecology department at K.S Hegde Charitable Hospital were enrolled in the study. A Papanicolaou smear and visual inspection of the cervix with acetic acid was done. All women then underwent colposcopy using the videocolposcope. All patients who tested positive on screening then underwent colposcopy guided biopsy. Pap smear of low grade squamous intraepithelial lesion (LSIL) and above was taken as abnormal. The statistical test used was chi square test and results were computed using SPSS version 12.0. Results: Out of 225 patients, VIA was positive in 27(12%) patients and pap smear was abnormal in 26(11.7%). There were 15 LSIL, 6 high grade squamous intraepithelial lesion (HSIL) and 5 were squamous cell carcinoma. On biopsy, there were 15 mild dysplasia, 2 moderate dysplasia, 4 severe dysplasia and 3 squamous cancers. Pap smear had a sensitivity of 83%, specificity of 98%, positive predictive value of 80 % and negative predictive value of 97.9%. VIA had a sensitivity of 70.8%, specificity of 95%, and positive predictive value of 62.9 % and negative predictive value of 96.5%. Conclusion : Since diagnostic values of VIA is comparable to pap smear, and it performs well in detecting high grade lesion we conclude that VIA can be used as a screening modality for cervical cancer in low resource settings. Keywords: visual inspection with acetic acid; pap smear- colposcopy; cervical cancer; low resource settings DOI: http://dx.doi.org/10.3126/hren.v9i3.5579 HR 2011; 9(3): 134-139

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Molecular epidemiology of human papillomavirus genotype in women with high-grade squamous intraepithelial lesion and cervical cancer: Will a quadrivalent vaccine be necessary in Thailand?

Journal of Medical Virology ◽

10.1002/jmv.21948 ◽

2010 ◽

Vol 83 (1) ◽

pp. 119-126 ◽

Cited By ~ 6

Author(s):

Chonlaphat Sukasem ◽

Wantanich Pairoj ◽

Nipa Saekang ◽

Hiranyaratsami Pombubpha ◽

Chutatip Srichunrasami ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Molecular Epidemiology ◽

Quadrivalent Vaccine ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion

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Case Report: Noninvasive Clinical Intervention of REBACIN® on Histologic Regression of High Grade Cervical Intraepithelial Neoplasia

Frontiers in Medicine ◽

10.3389/fmed.2021.627355 ◽

2021 ◽

Vol 8 ◽

Author(s):

Fan Wang ◽

Rong Liu ◽

Yan Ma ◽

Dai-Fei Wu ◽

Liu-Hong Deng ◽

...

Keyword(s):

Cervical Cancer ◽

High Risk ◽

Clinical Intervention ◽

Intraepithelial Neoplasia ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Non Invasive ◽

Future Fertility ◽

Intraepithelial Lesion ◽

High Risk Hpv

High-risk human papillomavirus (hrHPV) persistent infection is the major cause of cervical cancer. Clinical intervention of hrHPV-associated high-grade squamous intraepithelial lesion (HSIL) is critical to prevent cervical cancer, and current treatment is surgery (an invasive therapy). However, some patients refuse to do so for an afraid of potential adverse effects on future fertility or other concerns which creates a critical need for development of non-invasive therapeutic strategies. Here, we report for the first time the cases of non-invasive intervention with REBACIN®, a proprietary antiviral biologics, in clinical treatment of HSIL. From 12,958 visiting patients assessed for eligibility, 18 HSIL-patients with cervical intraepithelial neoplasia-grade 2, positive of both diffused overexpression of p16 and high-risk HPV were enrolled in this non-invasive clinical intervention mainly due to concerns of future fertility. REBACIN® was administered intravaginally every other day for 3 months (one-course) except during menstrual period, and were followed up for 6-36 months for the examination of high-risk HPV DNA, cervical cytology, and histopathology. After one to three course treatments, most cases (16/18) displayed both the regression from HSIL (CIN2) to normal cervical cytology and clearance of high-risk HPV infection. Further studies demonstrated REBACIN® significantly suppressed HPV16 E7 oncoprotein expression in a human cervical cancer cell line, which is consistent with previous finding that REBACIN® inhibits the growth of tumors induced by expression of E6/E7 oncogenes of either HPV16 or HPV18. This report indicates REBACIN® as a novel effective non-invasive clinical intervention for HSIL-patients as well for high-risk HPV persistent infection, providing a new clinical option for the non-invasive treatment of hrHPV-associated high-grade squamous intraepithelial lesion, which is worthy of further research on clinical validation and application.

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