High-risk human papillomavirus persistence and other molecular genetic predictors for cervical intraepithelial neoplasias

Objective. To analyze the signif icance of high-risk human papillomavirus (hrHPV) persistence, viral load, and mRNA expression of the MKI67, CDKN2A, PGR, and BCI2 genes in predicting the development of squamous intraepithelial lesions (SIL). Subjects and methods. The investigation included 85 women (mean age, 34+11 years) with NIIM cytology and positive hrHPV. A comprehensive clinical and laboratory examination involved HPV typing with viral load assessment; real-time PCR assay of the mRNA expression of human genes; liquid cytology; extended colposcopy once every 12 months during 2-year follow-up, and cervical biopsy (if indicated). Results. There were 2 groups: la) 52 (61%) patients with transient papillomavirus infection and a persistent negative response, lb) 12 (14%) with transient infection and an unstable negative response; 2) 21 (25%) with persistent hrHPV. There was a worse colposcopic pattern in 12 (57%) patients in the persistent hrHPV group. There was persistence of HPV types (16, 31, 39, 52, 18, and 68). Histologically, SII was verified for 2 years only in Group II: ISII in 10(47%) and HSII in 1 (5%); 6 (55%) of them had changes in the mRNA expression of the MKI67, CDKN2A, PGR and BCI2 genes. Conclusion. Persistent hrHPV with changes in the mRNA expression of the MKI67, CDKN2A, PGR, and BCI2 genes and in the colposcopic pattern are considered as markers for SII progression.

cervical intraepithelial neoplasia, human papillomavirus, cervical cancer, mRNA expression