Immunotherapy in patients with local HPV infection and high-grade squamous intraepithelial lesion following uterine cervical conization

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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Comparison of Monopolar Electrosurgical Conization and the Loop Electrosurgical Excision Procedure in the Management of High-Grade Squamous Intraepithelial Lesion

Frontiers in Surgery ◽

10.3389/fsurg.2021.721545 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jun Ding ◽

Haiou Xu ◽

Lihua Xia ◽

Shanshan Cao ◽

Qing Wu

Keyword(s):

Burn Injury ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Abnormal Cervical Cytology ◽

Significant Difference ◽

The Status ◽

Intraepithelial Lesion ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure ◽

Cervical Conization

Objectives: To compare the performance and outcomes of monopolar electrosurgical conization (MESC) or the loop electrosurgical excision procedure (LEEP) in the treatment of high-grade squamous intraepithelial lesion (HSIL).Methods: This retrospective study included 554 patients diagnosed with HSIL through biopsy. The study used either LEEP or MESC for cervical conization. Additionally, the medical records of these patients, including the basic information, status of the excision margin, cone depth, cone width, fragmentation, complication, and the results of a 6-month follow-up after conization, were reviewed.Results: Compared to MESC, LEEP had a significantly higher rate of positive endocervical margin (3.77 vs. 8.65%; p = 0.018), burn injury of the margin (4.90 vs. 10.38%; p = 0.016) and a lower rate of adequate cone depth (83.40 vs. 89.62%; p = 0.034). In addition, LEEP was significantly more likely to cause fragmentation (p = 0.000). There was, however, no significant difference in the rate of abnormal cervical cytology and positive high-risk HPV (hrHPV) between these two groups, 6 months after cervical conization.Conclusion: Both LEEP and MESC appeared to be equally effective in the clinical treatment of HSIL. Nonetheless, MESC resulted in a better pathological outcome with regard to the status of the margin, tissue fragmentation, and cone depth.

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PREVALENCE OF HUMAN PAPILLOMAVIRUS GENOTYPES IN LOW AND HIGH GRADE SQUAMOUS INTRAEPITHELIAL LESIONS AT CERVICAL TISSUE

Folia Medica Indonesiana ◽

10.20473/fmi.v53i4.7157 ◽

2017 ◽

Vol 53 (4) ◽

pp. 258

Author(s):

Rizki Eko Prasetyo ◽

Gondo Mastutik ◽

Sjahjenny Mustokoweni

Keyword(s):

Precancerous Lesions ◽

Hpv Infection ◽

Multiple Infection ◽

Single Infection ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Cervical Precancerous Lesions ◽

Intraepithelial Lesion ◽

Intraepithelial Lesions

HPV infection is known to cause cervical cancer. This study aimed to identify the variant of HPV genotypes of cervical precancerous lesions from low grade squamous intraepithelial lesion (LSIL) and high grade squamous intraepithelial lesion (HSIL). This was an explorative study using formalin fix paraffin embedded (FFPE) from cervical precancerous lesions at Dr. Soetomo Hospital, Surabaya. DNA was extracted from FFPE and hybridized for HPV genotyping using Ampliquality HPV Type Express kit (AB ANALITICA) by reverse line blot techniques. The results showed that there were variants of HPV genotype in LSIL. The variants were HPV16 (8/15), HPV18 (3/15), HPV52 (1/15), HPV6+31 (1/15), HPV6+18 (1/15), and HPV72+68 (1/15), and in HSIL which were HPV16 (4/10), HPV18 (2/10), HPV59 (1/10), HPV6+45 (1/10), HPV61+26 (1/10), and HPV16+31 (1/10). The characteristics of infection in LSIL were single infection of high-risk (hr) HPV and multiple infection of low-risk (lr)+hr HPV, and in HSIL were single infection of HPVhr, multiple infection of HPVhr+hr and HPVlr+hr. In conclusion, HPV prevalence in cervical precancerous lesions is single infection by HPV16 (48%), HPV18 (20%), HPV52 (4%), HPV59 (4%), and multiple infection by HPV6+31, HPV6+18, HPV6+45, HPV16+31, HPV61+26, HPV72+68 is 4%.

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Absence or Presence of High-Grade Squamous Intraepithelial Lesion in Cervical Conization Specimens

American Journal of Clinical Pathology ◽

10.1093/ajcp/aqv007 ◽

2015 ◽

Vol 145 (1) ◽

pp. 96-100 ◽

Cited By ~ 1

Author(s):

Vighnesh Walavalkar ◽

Thomas Stockl ◽

Christopher L. Owens ◽

Mark Manning ◽

Debra Papa ◽

...

Keyword(s):

High Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion ◽

Cervical Conization

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Loop electrosurgical excision procedure versus expectant management to treat high-grade squamous intraepithelial lesion in women up to 25 years

The Journal of Genital Surgery ◽

10.21608/jgs.2018.2590.1011 ◽

2017 ◽

Vol 1 (Ready articles) ◽

pp. 1-5

Author(s):

Dantas Macerly ◽

Gonçalves Ana ◽

Mesquita Ada ◽

Batista Fabiana ◽

Souza Angélica ◽

...

Keyword(s):

Expectant Management ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion ◽

Loop Electrosurgical Excision ◽

Loop Electrosurgical Excision Procedure

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Low Utility in Colposcopy-directed Biopsies for Non-high Grade Cytological Abnormalities on PAP Smear

Current Women s Health Reviews ◽

10.2174/1573404815666190821093421 ◽

2020 ◽

Vol 16 (1) ◽

pp. 18-22

Author(s):

Eronmwon E. Gbinigie ◽

Joshua Fogel ◽

Maggie Tetrokalashvili

Keyword(s):

Pap Smear ◽

Multinomial Logistic Regression ◽

Cervical Dysplasia ◽

Outcome Variable ◽

Low Grade ◽

High Grade ◽

Squamous Intraepithelial Lesion ◽

Intraepithelial Lesion ◽

Cytologic Abnormalities ◽

Cytology Screening

Background: Clinicians commonly perform colposcopy directed biopsies on patients with low grade squamous intraepithelial lesion (LSIL) on PAP cytology even when not consistent with clinical guidelines. Objective: We study the association of PAP cytology screening results with cervical intra-epithelia neoplasia (CIN) 2-3 high-grade dysplasia, as confirmed by colposcopy-directed biopsy. Methods: A retrospective study of 263 women with an abnormality on the PAP smear. Multinomial logistic regression was performed with predictors of PAP cytology screening results with the outcome variable of colposcopy-directed biopsy. Results: High grade squamous intraepithelial lesion (HSIL) had significantly increased relative risk for CIN 2-3 (RR: 9.85, 95% CI: 1.84, 52.79, p=0.008). LSIL was not significantly associated with CIN 2-3. In the comparisons of negative with CIN-1, both HSIL and LSIL were not significantly associated with a negative biopsy. Conclusion: HSIL is associated with cervical dysplasia of CIN 2-3 while LSIL is not associated with cervical dysplasia of CIN 2-3. We do not recommend routine biopsies in patients with LSIL cytologic abnormalities unless additional compelling factors exist.

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