A1 Refereed original research article in a scientific journal
Methylation in Predicting Progression of Untreated High-grade Cervical Intraepithelial Neoplasia
Authors: Karolina Louvanto, Karoliina Aro, Belinda Nedjai, Ralf Bützow, Maija Jakobsson, Ilkka Kalliala, Joakim Dillner, Pekka Nieminen, Attila Lorincz
Publisher: Oxford University Press
Publication year: 2019
Journal: Clinical Infectious Diseases
Journal name in source: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
Journal acronym: Clin Infect Dis
ISSN: 1058-4838
eISSN: 1537-6591
DOI: https://doi.org/10.1093/cid/ciz677
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/45532757
BackgroundThere is no prognostic test to ascertain whether cervical intraepithelial neoplasias (CINs) regress or progress. The majority of CINs regress in young women, and treatments increase the risk of adverse pregnancy outcomes. We investigated the ability of a DNA methylation panel (the S5 classifier) to discriminate between outcomes among young women with untreated CIN grade 2 (CIN2).MethodsBaseline pyrosequencing methylation and human papillomavirus (HPV) genotyping assays were performed on cervical cells from 149 women with CIN2 in a 2-year cohort study of active surveillance.ResultsTwenty-five lesions progressed to CIN grade 3 or worse, 88 regressed to less than CIN grade 1, and 36 persisted as CIN1/2. When cytology, HPV16/18 and HPV16/18/31/33 genotyping, and the S5 classifier were compared to outcomes, the S5 classifier was the strongest biomarker associated with regression vs progression. The S5 classifier alone or in combination with HPV16/18/31/33 genotyping also showed significantly increased sensitivity vs cytology when comparing regression vs persistence/progression. With both the S5 classifier and cytology set at a specificity of 38.6% (95% confidence interval [CI], 28.4–49.6), the sensitivity of the S5 classifier was significantly higher (83.6%; 95% CI, 71.9–91.8) than of cytology (62.3%; 95% CI, 49.0–74.4; P = 0.005). The highest area under the curve was 0.735 (95% CI, 0.621–0.849) in comparing regression vs progression with a combination of the S5 classifier and cytology, whereas HPV genotyping did not provide additional information.ConclusionsThe S5 classifier shows high potential as a prognostic biomarker to identify progressive CIN2.
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