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

Diagnosis and treatment of cervical cancer precursors rely on colposcopic 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...

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Veröffentlicht in:International journal of cancer 2009-02, Vol.124 (4), p.964-969
Hauptverfasser: Wentzensen, Nicolas, Schiffman, Mark, Dunn, S. Terence, Zuna, Rosemary E., Walker, Joan, Allen, Richard A., Zhang, Roy, Sherman, Mark E., Wacholder, Sholom, Jeronimo, Jose, Gold, Michael A., Wang, Sophia S.
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container_issue 4
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container_title International journal of cancer
container_volume 124
creator Wentzensen, Nicolas
Schiffman, Mark
Dunn, S. Terence
Zuna, Rosemary E.
Walker, Joan
Allen, Richard A.
Zhang, Roy
Sherman, Mark E.
Wacholder, Sholom
Jeronimo, Jose
Gold, Michael A.
Wang, Sophia S.
description Diagnosis and treatment of cervical cancer precursors rely on colposcopic 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 ∼1,700 women referred to colposcopy or treatment for the spectrum of cervical disease, including 439 women with
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Terence ; Zuna, Rosemary E. ; Walker, Joan ; Allen, Richard A. ; Zhang, Roy ; Sherman, Mark E. ; Wacholder, Sholom ; Jeronimo, Jose ; Gold, Michael A. ; Wang, Sophia S.</creator><creatorcontrib>Wentzensen, Nicolas ; Schiffman, Mark ; Dunn, S. Terence ; Zuna, Rosemary E. ; Walker, Joan ; Allen, Richard A. ; Zhang, Roy ; Sherman, Mark E. ; Wacholder, Sholom ; Jeronimo, Jose ; Gold, Michael A. ; Wang, Sophia S.</creatorcontrib><description>Diagnosis and treatment of cervical cancer precursors rely on colposcopic 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 ∼1,700 women referred to colposcopy or treatment for the spectrum of cervical disease, including 439 women with &lt;CIN1, 429 CIN1, 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 HPV‐positive women: (i) HPV‐positive women with &lt;CIN2 histology and normal cytology, (ii) HPV positive women with &lt;CIN2 histology and ASC or LSIL cytology; (iii) CIN2, including histologic CIN2 and HSIL cytology with any histology &lt;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 biomarkers predicting the risk of progression and invasion. © 2008 Wiley‐Liss, Inc.</description><identifier>ISSN: 0020-7136</identifier><identifier>EISSN: 1097-0215</identifier><identifier>DOI: 10.1002/ijc.23969</identifier><identifier>PMID: 19030188</identifier><identifier>CODEN: IJCNAW</identifier><language>eng</language><publisher>Hoboken: Wiley Subscription Services, Inc., A Wiley Company</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Biological and medical sciences ; biomarker ; Biomarkers, Tumor ; Biopsy ; cervical cancer ; Cervical Intraepithelial Neoplasia - diagnosis ; Cervical Intraepithelial Neoplasia - epidemiology ; Cervical Intraepithelial Neoplasia - genetics ; Cervical Intraepithelial Neoplasia - virology ; CIN ; Colposcopy - methods ; Disease Progression ; epidemiology ; Female ; Female genital diseases ; Genes, Viral ; Genotype ; Gynecology. Andrology. 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Terence</creatorcontrib><creatorcontrib>Zuna, Rosemary E.</creatorcontrib><creatorcontrib>Walker, Joan</creatorcontrib><creatorcontrib>Allen, Richard A.</creatorcontrib><creatorcontrib>Zhang, Roy</creatorcontrib><creatorcontrib>Sherman, Mark E.</creatorcontrib><creatorcontrib>Wacholder, Sholom</creatorcontrib><creatorcontrib>Jeronimo, Jose</creatorcontrib><creatorcontrib>Gold, Michael A.</creatorcontrib><creatorcontrib>Wang, Sophia S.</creatorcontrib><title>Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women referred to colposcopy in Oklahoma</title><title>International journal of cancer</title><addtitle>Int J Cancer</addtitle><description>Diagnosis and treatment of cervical cancer precursors rely on colposcopic 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 ∼1,700 women referred to colposcopy or treatment for the spectrum of cervical disease, including 439 women with &lt;CIN1, 429 CIN1, 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 HPV‐positive women: (i) HPV‐positive women with &lt;CIN2 histology and normal cytology, (ii) HPV positive women with &lt;CIN2 histology and ASC or LSIL cytology; (iii) CIN2, including histologic CIN2 and HSIL cytology with any histology &lt;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 biomarkers predicting the risk of progression and invasion. © 2008 Wiley‐Liss, Inc.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Biological and medical sciences</subject><subject>biomarker</subject><subject>Biomarkers, Tumor</subject><subject>Biopsy</subject><subject>cervical cancer</subject><subject>Cervical Intraepithelial Neoplasia - diagnosis</subject><subject>Cervical Intraepithelial Neoplasia - epidemiology</subject><subject>Cervical Intraepithelial Neoplasia - genetics</subject><subject>Cervical Intraepithelial Neoplasia - virology</subject><subject>CIN</subject><subject>Colposcopy - methods</subject><subject>Disease Progression</subject><subject>epidemiology</subject><subject>Female</subject><subject>Female genital diseases</subject><subject>Genes, Viral</subject><subject>Genotype</subject><subject>Gynecology. 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Andrology. Obstetrics</topic><topic>HPV</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Models, Biological</topic><topic>molecular</topic><topic>Oklahoma</topic><topic>Papillomaviridae - genetics</topic><topic>Risk</topic><topic>SUCCEED</topic><topic>Tumors</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - genetics</topic><topic>Uterine Cervical Neoplasms - virology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Wentzensen, Nicolas</creatorcontrib><creatorcontrib>Schiffman, Mark</creatorcontrib><creatorcontrib>Dunn, S. 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Terence</au><au>Zuna, Rosemary E.</au><au>Walker, Joan</au><au>Allen, Richard A.</au><au>Zhang, Roy</au><au>Sherman, Mark E.</au><au>Wacholder, Sholom</au><au>Jeronimo, Jose</au><au>Gold, Michael A.</au><au>Wang, Sophia S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women referred to colposcopy in Oklahoma</atitle><jtitle>International journal of cancer</jtitle><addtitle>Int J Cancer</addtitle><date>2009-02-15</date><risdate>2009</risdate><volume>124</volume><issue>4</issue><spage>964</spage><epage>969</epage><pages>964-969</pages><issn>0020-7136</issn><eissn>1097-0215</eissn><coden>IJCNAW</coden><abstract>Diagnosis and treatment of cervical cancer precursors rely on colposcopic 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 ∼1,700 women referred to colposcopy or treatment for the spectrum of cervical disease, including 439 women with &lt;CIN1, 429 CIN1, 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 HPV‐positive women: (i) HPV‐positive women with &lt;CIN2 histology and normal cytology, (ii) HPV positive women with &lt;CIN2 histology and ASC or LSIL cytology; (iii) CIN2, including histologic CIN2 and HSIL cytology with any histology &lt;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 biomarkers predicting the risk of progression and invasion. © 2008 Wiley‐Liss, Inc.</abstract><cop>Hoboken</cop><pub>Wiley Subscription Services, Inc., A Wiley Company</pub><pmid>19030188</pmid><doi>10.1002/ijc.23969</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record>
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source MEDLINE; Wiley Online Library Journals Frontfile Complete; EZB-FREE-00999 freely available EZB journals
subjects Adolescent
Adult
Aged
Aged, 80 and over
Biological and medical sciences
biomarker
Biomarkers, Tumor
Biopsy
cervical cancer
Cervical Intraepithelial Neoplasia - diagnosis
Cervical Intraepithelial Neoplasia - epidemiology
Cervical Intraepithelial Neoplasia - genetics
Cervical Intraepithelial Neoplasia - virology
CIN
Colposcopy - methods
Disease Progression
epidemiology
Female
Female genital diseases
Genes, Viral
Genotype
Gynecology. Andrology. Obstetrics
HPV
Human papillomavirus
Humans
Medical sciences
Middle Aged
Models, Biological
molecular
Oklahoma
Papillomaviridae - genetics
Risk
SUCCEED
Tumors
Uterine Cervical Neoplasms - diagnosis
Uterine Cervical Neoplasms - epidemiology
Uterine Cervical Neoplasms - genetics
Uterine Cervical Neoplasms - virology
title Grading the severity of cervical neoplasia based on combined histopathology, cytopathology, and HPV genotype distribution among 1,700 women referred to colposcopy in Oklahoma
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