Abstract
To identify the risk factors and assess the role of survivin in predicting progessivity precancerous cervical lesions. This case-control study was conducted from October 2009 until May 2010. We obtained 74 samples, classified according to the degree of cervical intraepithelial neoplasia (CIN): 19 samples for CIN 1, 18 samples for CIN 2, 18 samples for CIN 3, and 19 samples as controls. Demographic profiles and risk factors assesment, histopathologic examination, HPV DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples. Data was analyzed with bivariate and multivariate analysis. Multivariate analysis revealed significant risk factors for developing precancerous cervical lesions are age <41 years, women with ≥2 sexual partners, course of education ≥13 years, use of oral contraceptives, positive high-risk HPV DNA, and high survivin expression by ICC or IHC staining. These factors were fit to a prediction model and we obtained a scoring system to predict the progressivity of CIN lesions. Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of CIN lesions. Application of this scoring system may be beneficial in determining the action of therapy towards the patient.
Highlights
Cervical cancer is the second most frequent cancer in women throughout the world, and contributes to most deaths caused by gynecological cancers
Demographic profiles and risk factors assesment, histopathologic examination, Human papilloma virus (HPV) DNA tests, immunocytochemistry (ICC) and immunohistochemistry (IHC) staining for survivin expression were performed on all samples
Determination of survivin expression by immunocytochemistry staining, along with other significant risk factors, can be used in a scoring system to predict the progressivity of cervical intraepithelial neoplasia (CIN) lesions
Summary
Cervical cancer is the second most frequent cancer in women throughout the world, and contributes to most deaths caused by gynecological cancers. Recent findings in the molecular carcinogenesis by HPV has expanded new areas of study, such as potential biomarkers. These biomarkers may be used to detect precancerous lesions, to enhance diagnostic sensitivity, to predict the prognosis, and/or to be considered when choosing the mode of therapy (Tan, 2010). Malignancy is related to disruptions in the cell cycle and may express survivin (Li, 2005). Another mechanism for survivin upregulation in cervical carcinogenesi is its normal transcriptional repression by wild-type p53 being eliminated by oncoprotein E6 in high-risk HPV (Branca, 2005)
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