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Biomarkers differentiating regression from progression among untreated cervical intraepithelial neoplasia grade 2 lesions
Journal of Advanced Research ( IF 11.4 ) Pub Date : 2024-09-12 , DOI: 10.1016/j.jare.2024.09.009 Xiang Li 1 , Yan Chen 2 , Jing Xiong 3 , Puxiang Chen 3 , Dongdong Zhang 4 , Qing Li 5 , Peng Zhu 5
中文翻译：
区分未经治疗的宫颈上皮内瘤变 2 级病变的消退与进展的生物标志物
宫颈上皮内瘤变2级（CIN2）是宫颈病变发展为宫颈癌的前驱阶段之一。 CIN2 的自发发展尚不明确。 CIN2病变的一部分将进展为宫颈上皮内瘤变3级或更严重（CIN3+），另一部分将消退为宫颈上皮内瘤变1级或更低（CIN1−），最后一部分将持续存在。尽管指南建议有生育要求的CIN2患者可以采取保守治疗，以最大程度地降低不孕和产科并发症的风险，但大多数CIN2患者会接受手术治疗以防止病情进展，这会导致过度治疗和不必要的并发症。
This review summarized the biomarkers predicting the spontaneous regression of CIN2, which correlated with HPV infection, the (epi)genetic change of host genes and microenvironment change. However, potential biomarkers must be validated with prospective cohort studies, which should be conducted with expanded enrollment, a longer observational period and the tracking of more patients.
更新日期：2024-09-12
Journal of Advanced Research ( IF 11.4 ) Pub Date : 2024-09-12 , DOI: 10.1016/j.jare.2024.09.009 Xiang Li 1 , Yan Chen 2 , Jing Xiong 3 , Puxiang Chen 3 , Dongdong Zhang 4 , Qing Li 5 , Peng Zhu 5
Affiliation
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Background
Cervical intraepithelial neoplasia grade 2 (CIN2) is one of the precursor stages before cervical lesions develop into cervical cancer. The spontaneous development of CIN2 is ambiguous. One part of CIN2 lesions will progress to cervical intraepithelial neoplasia grade 3 or worse (CIN3+), another part will regress to cervical intraepithelial neoplasia grade 1 or less (CIN1−), and the last part will persist. Although the guidelines suggest that CIN2 patients with fertility requirements can be treated conservatively to minimize the risk of infertility and obstetric complications, most CIN2 patients undergo surgical treatment to prevent the progression of the disease, which will lead to over-treatment and unnecessary complications.Aim of review
The clinical outcome of CIN2 lesions is unpredictable and depends on histopathological examinations. Thus, it is necessary to identify the biomarkers differentiating regression lesions from progression lesions, which is conducive to supporting individualised treatment. The natural history of CIN2 is commonly regulated by the interaction of human papillomavirus (HPV) viral factors (HPV genotype and HPV methylation), host factors (p16/Ki-67 status, host gene methylation effects, human leukocyte antigen subtypes and immune microenvironment) and other factors (vaginal microbiota).Key scientific concepts of review
This review summarized the biomarkers predicting the spontaneous regression of CIN2, which correlated with HPV infection, the (epi)genetic change of host genes and microenvironment change. However, potential biomarkers must be validated with prospective cohort studies, which should be conducted with expanded enrollment, a longer observational period and the tracking of more patients.中文翻译：
区分未经治疗的宫颈上皮内瘤变 2 级病变的消退与进展的生物标志物
背景
宫颈上皮内瘤变2级（CIN2）是宫颈病变发展为宫颈癌的前驱阶段之一。 CIN2 的自发发展尚不明确。 CIN2病变的一部分将进展为宫颈上皮内瘤变3级或更严重（CIN3+），另一部分将消退为宫颈上皮内瘤变1级或更低（CIN1−），最后一部分将持续存在。尽管指南建议有生育要求的CIN2患者可以采取保守治疗，以最大程度地降低不孕和产科并发症的风险，但大多数CIN2患者会接受手术治疗以防止病情进展，这会导致过度治疗和不必要的并发症。
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