DNA Methylation Classifier Predicts Progression in CIN2

A DNA methylation classifier can predict progression in young women with untreated cervical intraepithelial neoplasia grade 2 (CIN2), according to a study published online in Clinical Infectious Diseases.

Karolina Louvanto, Ph.D., from Turku University Hospital in Finland, and colleagues examined the ability of a DNA methylation panel (S5 classifier) to discriminate between progression and regression among 149 young women with CIN2.

The researchers found that 25, 88, and 36 lesions progressed to CIN grade 3 or worse, regressed to less than CIN grade 1, and persisted as CIN1/2, respectively. S5 was the strongest biomarker associated with regression versus progression when cytology, human papillomavirus (HPV)16/18- and HPV16/18/31/33-genotyping, and S5 at baseline were compared with outcomes. Comparing regression versus persistence/progression, S5 alone or in combination with HPV16/18/31/33-genotyping also showed significantly increased sensitivity versus cytology. With both S5 and cytology testing set to a specificity to 38.6 percent, S5 sensitivity was 83.6 percent, which was significantly higher than cytology (62.3 percent). For the regression versus progression outcome, the highest area under the curve was 0.735 with a combination of S5 and cytology; no additional prognostic information was provided by HPV16/18- and HPV16/18/31/33-genotyping.

"It is scary for young women with a potentially serious dysplasia to be told that they may get cancer if they do not undergo surgery. Unfortunately, surgery can lead to a painful and distressing recovery period. In future pregnancies there are substantially higher rates of miscarriage, infection, or premature delivery for mothers as well as many risks for the fetus," a coauthor said in a statement. "Our study shows that most women with moderate dysplasia can be followed without treatment until their disease regresses. This gives the women a better chance for easy and safe pregnancies in the future."

One author disclosed financial ties to the biopharmaceutical industry.

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