Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women

Nicolas Wentzerisen, Mark Schiffman, S. Terence Dunn, Rosemary E. Zuna, Joan Walker, Richard A. Allen, Roy Zhang, Mark E. Sherman, Sholom Wacholder, Jose Jeronimo, Michael A. Gold, Sophia S. Wang

Research output: Contribution to journalArticle

60 Citations (Scopus)

Abstract

Diagnosis and treatment of cervical cancer precursors rely on colposcopy biopsy, which is sometimes hampered by incorrect biopsy placement and the unclear prognostic value of poorly reproducible diagnoses such as cervical intraepithelial neoplasia (CIN) Grade 1 and 2. Searching for discrete disease categories that incorporate the value of cytology and that reflect the causal role of particular HPV types, we analyzed histology, cytology and HPV genotype distributions in the Study to Understand Cervical Cancer Endpoints and Early Determinants (SUCCEED). This cross-sectional study comprises∼ 1,7(Ml women referred to colposcopy or treatment for the spectrum of cervical disease, including 439 women with <CIN1, 429 CIM, 322 CIN2, 297 CIN3 and 107 with cancer. Using hierarchical clustering of histology-cytology groups based on HPV genotype distributions, we could plainly distinguish in this referral population 5 increasingly severe diagnostic groups of HP\ -positive women: (i) UP\ -positive women with <CIN2 histology and normal cytologv, (ii) HPV positive women with <CIN2 histology and ASC or LSIL cytology; (iii) CIN2, including histologic CIN2 and HSIL cytology with any histology <CIN2; (iv) CIN3; and (v) invasive cervical cancer. The grouping of women with HSIL cytology, but without histological abnormalities to women with CIN2 suggests that in these cases the worst lesion was missed during colposcopy-biopsy. We are now using these sharpened diagnostic categories to search for novel bio-markers predicting the risk of progression and invasion.

Original languageEnglish (US)
Pages (from-to)964-969
Number of pages6
JournalInternational Journal of Cancer
Volume124
Issue number4
DOIs
StatePublished - Feb 15 2009

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Cell Biology
Genotype
Histology
Colposcopy
Neoplasms
Uterine Cervical Neoplasms
Biopsy
Cervical Intraepithelial Neoplasia
Cluster Analysis
Referral and Consultation
Cross-Sectional Studies
Therapeutics
Population

Keywords

  • Biomarker
  • Cervical cancer
  • CIN
  • Molecular

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Medicine(all)

Cite this

Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women. / Wentzerisen, Nicolas; Schiffman, Mark; Terence Dunn, S.; Zuna, Rosemary E.; Walker, Joan; Allen, Richard A.; Zhang, Roy; Sherman, Mark E.; Wacholder, Sholom; Jeronimo, Jose; Gold, Michael A.; Wang, Sophia S.

In: International Journal of Cancer, Vol. 124, No. 4, 15.02.2009, p. 964-969.

Research output: Contribution to journalArticle

Wentzerisen, N, Schiffman, M, Terence Dunn, S, Zuna, RE, Walker, J, Allen, RA, Zhang, R, Sherman, ME, Wacholder, S, Jeronimo, J, Gold, MA & Wang, SS 2009, 'Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women', International Journal of Cancer, vol. 124, no. 4, pp. 964-969. https://doi.org/10.1002/ijc.23969
Wentzerisen, Nicolas ; Schiffman, Mark ; Terence Dunn, S. ; Zuna, Rosemary E. ; Walker, Joan ; Allen, Richard A. ; Zhang, Roy ; Sherman, Mark E. ; Wacholder, Sholom ; Jeronimo, Jose ; Gold, Michael A. ; Wang, Sophia S. / Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women. In: International Journal of Cancer. 2009 ; Vol. 124, No. 4. pp. 964-969.
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