HPV vaccine protein L1 predicts disease outcome of high-risk HPV+ early squamous dysplastic lesions.
Prediction of the clinical outcome of nonadvanced, early dysplastic lesions is one of the unresolved problems of cervical cancer screening programs. We examined the influence of human papillomavirus (HPV) L1 capsid protein detection in a randomized, prospective study of 187 high-risk HPV+ early dysplastic lesions during 36 to 46 months. The difference in the clinical outcome of the HPV L1- cases and the HPV L1+ cases was highly statistically significant (P < .0001) and independent of the classification of low-grade squamous intraepithelial lesion (mild dysplasia) and high-grade squamous intraepithelial lesion of the moderate dysplastic type. L1+ mild and moderate dysplasias, reflecting productive HPV infection, showed low malignant potential, justifying a wait-and-watch strategy to prevent overtreatment, especially in young women. L1- early dysplastic lesions, as nonproductive infections or precancerous lesions, have a high malignancy potential and close follow-up with colposcopy and histologic evaluation should be advised.
Griesser
Henrik
H
Center of Pathology and Cytodiagnostics, Cologne, Germany.
Sander
Heinz
H
Walczak
Cindy
C
Hilfrich
Ralf A
RA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000378:metabolism*; D036022:Capsid Proteins / Q000378:metabolism*; D002467:Cell Nucleus / Q000737:chemistry / Q000473:pathology / Q000821:virology; D005260:Female; D006801:Humans; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000378:metabolism*; D027383:Papillomaviridae / Q000302:isolation & purification / Q000378:metabolism; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000821:virology; D014626:Vaginal Smears / Q000379:methods; D055815:Young Adult
D014408:Biomarkers, Tumor; D036022:Capsid Proteins; C114580:HPV L1 protein, Human papillomavirus; D009856:Oncogene Proteins, Viral