Cargando…
The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review
SIMPLE SUMMARY: Human papillomaviruses (HPV) are common sexually transmitted infections and they are responsible for cervical cancer (CC), as well as for several other anogenital cancers. CC is the fourth leading cause of death in women with cancer, although it could be preventable by enforcement of...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2022
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312145/ https://www.ncbi.nlm.nih.gov/pubmed/36101337 http://dx.doi.org/10.3390/biology11070956 |
_version_ | 1784753771866226688 |
---|---|
author | Voidăzan, Septimiu Toader Dianzani, Caterina Husariu, Mădălina Aurelia Geréd, Bíborka Turdean, Sabin Gligore Uzun, Cosmina Cristina Kovacs, Zsolt Rozsnyai, Florin Francisc Neagu, Nicoleta |
author_facet | Voidăzan, Septimiu Toader Dianzani, Caterina Husariu, Mădălina Aurelia Geréd, Bíborka Turdean, Sabin Gligore Uzun, Cosmina Cristina Kovacs, Zsolt Rozsnyai, Florin Francisc Neagu, Nicoleta |
author_sort | Voidăzan, Septimiu Toader |
collection | PubMed |
description | SIMPLE SUMMARY: Human papillomaviruses (HPV) are common sexually transmitted infections and they are responsible for cervical cancer (CC), as well as for several other anogenital cancers. CC is the fourth leading cause of death in women with cancer, although it could be preventable by enforcement of optimal screening programs. The Pap smear is the standard screening test for CC and precancerous lesions, and a combination of Pap smear and HPV testing is generally recommended as a triage step before colposcopy. However, these tests cannot predict lesion progression, which is why several adjunctive biomarkers have been studied. Our aim was to summarize current scientific data on the role of these biomarkers, with a view to determining which biomarkers could help to more accurately establish the need for colposcopy and at the same time, to limit the number of unnecessary colposcopy referrals. ABSTRACT: Human papillomaviruses (HPVs) are common sexually transmitted infectious agents responsible for several anogenital and head and neck cancers. Cervical cancer (CC) is the fourth leading cause of death in women with cancer. The progression of a persistent HPV infection to cancer takes 15–20 years and can be preventable through screening. Cervical cytology (Pap smear) is the standard screening test for CC and precancerous lesions. For ASC-US and ASC-H lesions, a combination of Pap smear and HR-HPV analysis is recommended as a triage step before colposcopy. However, these tests cannot predict progression to CC. For this purpose, we summarized current scientific data on the role of p16/Ki-67 immunohistostaining, telomerase and fibronectin in predicting progression to CC. p16 and p16/Ki-67 dual staining (DS) were more specific than HR-HPV DNA testing for the detection of CIN2+/CIN3+ in women with ASC-US and LSIL. Similarly, hTERC FISH analysis significantly improved the specificity and positive predictive value of HPV DNA testing in differentiating CIN2+ from CIN2 cytological samples. In conclusion, p16 IHC, p16/Ki-67 DS and hTERC FISH amplification are all valid adjunctive biomarkers which significantly increase the sensitivity and specificity of cervical dysplasia diagnosis, especially when combined with HPV DNA testing. However, considering the global socioeconomic background, we can postulate that p16 and p16/ Ki-67 IHC can be used as a next step after positive cytology for ASC-US or LSIL specimens in low-income countries, instead of HPV DNA testing. Alternatively, if HPV DNA testing is covered by insurance, p16 or p16/Ki-67 DS and HPV DNA co-testing can be performed. In middle- and high-income countries, hTERC amplification can be performed as an adjunctive test to HPV DNA testing in women with ASC-US and LSIL. |
format | Online Article Text |
id | pubmed-9312145 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-93121452022-07-26 The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review Voidăzan, Septimiu Toader Dianzani, Caterina Husariu, Mădălina Aurelia Geréd, Bíborka Turdean, Sabin Gligore Uzun, Cosmina Cristina Kovacs, Zsolt Rozsnyai, Florin Francisc Neagu, Nicoleta Biology (Basel) Systematic Review SIMPLE SUMMARY: Human papillomaviruses (HPV) are common sexually transmitted infections and they are responsible for cervical cancer (CC), as well as for several other anogenital cancers. CC is the fourth leading cause of death in women with cancer, although it could be preventable by enforcement of optimal screening programs. The Pap smear is the standard screening test for CC and precancerous lesions, and a combination of Pap smear and HPV testing is generally recommended as a triage step before colposcopy. However, these tests cannot predict lesion progression, which is why several adjunctive biomarkers have been studied. Our aim was to summarize current scientific data on the role of these biomarkers, with a view to determining which biomarkers could help to more accurately establish the need for colposcopy and at the same time, to limit the number of unnecessary colposcopy referrals. ABSTRACT: Human papillomaviruses (HPVs) are common sexually transmitted infectious agents responsible for several anogenital and head and neck cancers. Cervical cancer (CC) is the fourth leading cause of death in women with cancer. The progression of a persistent HPV infection to cancer takes 15–20 years and can be preventable through screening. Cervical cytology (Pap smear) is the standard screening test for CC and precancerous lesions. For ASC-US and ASC-H lesions, a combination of Pap smear and HR-HPV analysis is recommended as a triage step before colposcopy. However, these tests cannot predict progression to CC. For this purpose, we summarized current scientific data on the role of p16/Ki-67 immunohistostaining, telomerase and fibronectin in predicting progression to CC. p16 and p16/Ki-67 dual staining (DS) were more specific than HR-HPV DNA testing for the detection of CIN2+/CIN3+ in women with ASC-US and LSIL. Similarly, hTERC FISH analysis significantly improved the specificity and positive predictive value of HPV DNA testing in differentiating CIN2+ from CIN2 cytological samples. In conclusion, p16 IHC, p16/Ki-67 DS and hTERC FISH amplification are all valid adjunctive biomarkers which significantly increase the sensitivity and specificity of cervical dysplasia diagnosis, especially when combined with HPV DNA testing. However, considering the global socioeconomic background, we can postulate that p16 and p16/ Ki-67 IHC can be used as a next step after positive cytology for ASC-US or LSIL specimens in low-income countries, instead of HPV DNA testing. Alternatively, if HPV DNA testing is covered by insurance, p16 or p16/Ki-67 DS and HPV DNA co-testing can be performed. In middle- and high-income countries, hTERC amplification can be performed as an adjunctive test to HPV DNA testing in women with ASC-US and LSIL. MDPI 2022-06-23 /pmc/articles/PMC9312145/ /pubmed/36101337 http://dx.doi.org/10.3390/biology11070956 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Systematic Review Voidăzan, Septimiu Toader Dianzani, Caterina Husariu, Mădălina Aurelia Geréd, Bíborka Turdean, Sabin Gligore Uzun, Cosmina Cristina Kovacs, Zsolt Rozsnyai, Florin Francisc Neagu, Nicoleta The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title | The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title_full | The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title_fullStr | The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title_full_unstemmed | The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title_short | The Role of p16/Ki-67 Immunostaining, hTERC Amplification and Fibronectin in Predicting Cervical Cancer Progression: A Systematic Review |
title_sort | role of p16/ki-67 immunostaining, hterc amplification and fibronectin in predicting cervical cancer progression: a systematic review |
topic | Systematic Review |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9312145/ https://www.ncbi.nlm.nih.gov/pubmed/36101337 http://dx.doi.org/10.3390/biology11070956 |
work_keys_str_mv | AT voidazanseptimiutoader theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT dianzanicaterina theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT husariumadalinaaurelia theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT geredbiborka theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT turdeansabingligore theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT uzuncosminacristina theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT kovacszsolt theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT rozsnyaiflorinfrancisc theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT neagunicoleta theroleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT voidazanseptimiutoader roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT dianzanicaterina roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT husariumadalinaaurelia roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT geredbiborka roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT turdeansabingligore roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT uzuncosminacristina roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT kovacszsolt roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT rozsnyaiflorinfrancisc roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview AT neagunicoleta roleofp16ki67immunostaininghtercamplificationandfibronectininpredictingcervicalcancerprogressionasystematicreview |