scholarly journals Biomarker Expression in Multifocal Vulvar High-Grade Squamous Intraepithelial Lesions

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5646
Author(s):  
Nikki B. Thuijs ◽  
Willemijn A. M. Schonck ◽  
Linde L. J. Klaver ◽  
Guus Fons ◽  
Marc van Beurden ◽  
...  

In patients with high-grade squamous intraepithelial lesion (HSIL) of the vulva, the presence of multiple lesions, called multifocal HSIL, is common. The aim of this exploratory study was to investigate biomarker expression profiles in multifocal HSIL. In total, 27 lesions from 12 patients with high-risk human papillomavirus (HPV)-positive multifocal HSIL were tested for HPV genotype, expression of p16INK4a and Ki-67, and DNA methylation of six genes. HPV16 was found most commonly in 21 (77.8%) HSILs. In two (16.4%) patients, HPV genotype differed between the lesions. All lesions demonstrated diffuse p16INK4a staining, of which three (11.1%) were combined with patchy staining. One patient (8.3%) demonstrated markedly different DNA methylation levels between lesions. Generally, heterogeneity in methylation profiles was observed between different patients, even when other biomarkers showed similar expression. In conclusion, this study is the first to demonstrate heterogeneity of individual lesions in patients with multifocal HSIL. The studied biomarkers have the potential to refine prognostic and predictive diagnostics. Future prospective, longitudinal studies are needed to further explore the potential of a biomarker profile for management of patients with multifocal HSIL.

2020 ◽  
Vol 16 (1) ◽  
pp. 87-93
Author(s):  
Piotr Lewitowicz ◽  
Anna Nasierowska-Guttmejer ◽  
Wojciech Rokita ◽  
Olga Adamczyk-Gruszka ◽  
Stanisław Gluszek ◽  
...  

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiao Li ◽  
Meihua Liu ◽  
Yurou Ji ◽  
Pengpeng Qu

Abstract Background The effectiveness of surgery of high-grade squamous intraepithelial lesion in post-menopausal women needs to be investigated. This study evaluated the clinical significance of cold-knife conization in the diagnosis and surgery of cervical high-grade squamous intraepithelial lesions in post-menopausal women. Methods We conducted a retrospective analysis of post- and pre-menopausal patients with high-grade squamous intraepithelial lesion. All patients received cold-knife conization as the primary therapy. Results The satisfactory rate of colposcopy was significantly lower in the post-menopausal group than in the pre-menopausal group (38.33 vs. 71.25%; χ2 = 36.202, P < 0.001). The overall positive margin rate of cold-knife conization (25.83 vs 12.50%; χ2 = 10.106, P = 0.001) and rate of positive endocervical cone margins (16.67 vs. 4.58%; χ2 = 14.843, P < 0.001) were significantly higher in the post-menopausal group. Moreover, 49 post- and 60 pre-menopausal women underwent subsequent surgical treatment (40.83 vs. 25.00%). Residual rate of positive and negative margins in patients before and after menopause was significantly different (χ2 = 5.711, P = 0.017; χ2 = 12.726, P < 0.001, respectively). The recurrence rate in post-menopausal women remained 3.85%. Conclusions Cold-knife conization can be performed as a primary procedure for diagnosis and surgery of post-menopausal patients with high-grade squamous intraepithelial lesions. Sufficient deep excisions are necessary to avoid positive endocervical margins, which can reduce the residual and recurrence of postoperative lesions.


2012 ◽  
Vol 55 (3) ◽  
pp. 339 ◽  
Author(s):  
José Eleutério ◽  
DianeM Cavalcante ◽  
IaraM Linhares ◽  
MargaridaM.L Pompeu ◽  
PauloC Giraldo

2007 ◽  
Vol 131 (4) ◽  
pp. 622-624
Author(s):  
Lisa N. Tyler ◽  
Nancy Andrews ◽  
Rudolph S. Parrish ◽  
Linda J. Hazlett ◽  
Soheila Korourian

Abstract Context.—High-grade squamous intraepithelial lesions (cervical intraepithelial neoplasia 2 and 3) are commonly treated with loop electrosurgery excision procedure (LEEP) biopsies. Objective.—To highlight the significance of positive margins and extent of positive margins of the cervical LEEP biopsies in predicting the persistence of high-grade squamous intraepithelial lesion and to provide suggestions for reporting margins in cervical LEEP biopsies. Design.—The pathology files at the University of Arkansas for Medical Sciences were searched for cervical intraepithelial neoplasia 2 and 3 treated by LEEP biopsy from 1990 to 2001. Results.—A total of 489 LEEP biopsy specimens were retrieved and reviewed; 270 patients had follow-up within 1 year. The biopsy specimens of 110 patients showed positive endocervical margins. One hundred sixty specimens had negative ectocervical-endocervical margins. Follow-up of 54% of the cases with initial positive margins showed residual high-grade squamous intraepithelial lesions. This association was even greater when multiple blocks showed positive endocervical margins and in cases with positive deep margins. On the other hand, a negative margin predicted ability to completely remove the lesion in 95% of patients. Conclusion.—This study reiterates the significance of the evaluation of the margin, even in samples that were received as multiple fragments. Reporting of LEEP biopsy findings should include the extent of the dysplasia, the status of the ectocervical-endocervical margin, and the status of the deep margin.


2004 ◽  
Vol 128 (7) ◽  
pp. 746-748 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Michael A. Schulte ◽  
Elizabeth Plott ◽  
Barbara Dubray-Benstein ◽  
Camilla J. Cobb ◽  
...  

Abstract Context.—Conventional Papanicolaou (Pap) test slides of high-grade squamous intraepithelial lesions (HSILs) that are frequently misdiagnosed are known to have relatively few dysplastic cells. Whether this is true of cases of HSIL in ThinPrep Pap Test specimens is not known. Objective.—To determine if cases of HSIL in ThinPrep specimens that are frequently missed have relatively few dysplastic cells. Design.—The cytologic features of 16 ThinPrep cases of HSIL that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 22 ThinPrep Pap Test cases that performed extremely well. Results.—Significantly more cases that performed poorly had fewer than 250 dysplastic cells (13/16) than cases that performed well (3/22) (P &lt; .001). Conclusion.—ThinPrep Pap Test cases with a diagnosis of HSIL that performed poorly in this program had significantly fewer dysplastic cells than those that performed well.


2005 ◽  
Vol 129 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Andrew A. Renshaw ◽  
Barbara Dubray-Benstein ◽  
Jennifer Haja ◽  
Jonathan H. Hughes

Abstract Context.—Both conventional and ThinPrep Papanicolaou smears with high-grade squamous intraepithelial lesions that are frequently missed are known to have relatively few abnormal cells. Whether this is also true of cases of low-grade squamous intraepithelial lesion is not known. Objective.—To compare the cytologic features of cases of low-grade squamous intraepithelial lesion that perform poorly with the features of cases that perform well. Design.—The cytologic features of 10 ThinPrep Pap Test and conventional smear cases of low-grade squamous intraepithelial lesion that performed poorly in the College of American Pathologists Interlaboratory Comparison Program were compared with 46 ThinPrep Pap Test and conventional smear cases that performed extremely well. The numbers of abnormal cells were categorized into less than 50, 51 to 100, 101 to 250, 251 to 500, and more than 500. Results.—The median number of abnormal cells for cases that performed poorly was less than 50, whereas the median number of abnormal cells for cases that performed well was between 101 and 250. Overall, cases that performed poorly were significantly more likely to have less than 50, less than 100, and less than 250 abnormal cells than cases that performed well (P &lt; .001, P &lt; .001, and P = .009, respectively). A minority of cases performed well even with very few abnormal cells and groups. The same findings were present when conventional smears and ThinPrep specimens were analyzed separately. Conclusions.—ThinPrep Pap Test cases and conventional smears with a diagnosis of low-grade squamous intraepithelial lesion that perform poorly in this program have significantly fewer abnormal cells than those that perform well. The median number of abnormal cells in cases that performed well is lower than that of comparable high-grade cases in the program.


1970 ◽  
Vol 2 (3) ◽  
pp. 180-185
Author(s):  
Shiva Raj KC ◽  
OP Talwar

Background: ‘AgNOR’ represents Nucleolar Organiser Regions stained with silver which are related to cell proliferation rate and tumor malignant potential. The objective of this study was to evaluate the role of AgNOR in differentiating benign and precancerous lesions from cancerous lesions in both cervical smears and histology. Materials and Methods: This was a prospective study conducted at Manipal Teaching Hospital, from July 2005 to June 2007. Women of suspected cervical pathology and who underwent pap smears test followed by subsequent biopsy were included. There were 53 cases were included out of which 11 cases were of high grade squamous intraepithelial lesion and 12 cases of low grade squamous intraepithelial lesion, and 10 cases each of carcinoma, chronic cervicitis with and without squamous metaplasia. Results: In Low grade squamous intraepithelial lesion meanAgNOR dots was < (2.9 in pap smears and 1.9 in histology) in high grade lesion (3.45 in pap smears and 3.00 in histology). In carcinoma meanAgNOR dots was 5.18 and 4.05 in pap smears and histology respectively. Subjective AgNOR Pattern Assessment in pap smears and in histology was increasing with significant difference from intraepithelial lesions to carcinoma. Conclusion: In cervical pathology, the number and shape of AgNOR dots change from benign to precancerous to malignant tumors. Similarly, AgNOR Pattern Assessment is useful in differentiating benign to intraepithelial lesions to carcinoma cases. DOI: http://dx.doi.org/10.3126/jpn.v2i3.6017 JPN 2012; 2(3): 180-185


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