title: Risk of progression of early cervical lesions is associated with integration and persistence of HPV-16 and expression of E6, Ki-67, and telomerase.
abstract: BACKGROUND
  Low-grade squamous intraepithelial lesions (LSIL) are the earliest lesions of the uterine cervix, the persistence and integration of high-risk human papillomavirus (HR-HPV) as type 16, which promotes the development of more aggressive lesions.
  
  
  OBJECTIVE
  To select more aggressive lesions with tendency to progress to invasive cervical cancer.
  
  
  METHODS
  A total of 75 cytological specimens in liquid base (Liqui-PREP) were analyzed: 25 specimens were with no signs of SIL (NSIL) and without HPV; 25 NSIL with HPV-16, and 25 with both LSIL and HPV-16. The expression of Ki-67, telomerase, and viral E6 was evaluated by immunocytochemistry; and the detection of viral DNA was done by polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLPs) for genotyping or sequencing of HPV-16. The physical state of HPV-16 was evaluated by in situ hybridization with amplification with tyramide.
  
  
  RESULTS
  Of the total group, 58.6% had LSIL associated with persistence and of these 59.3% was associated with integrated state of HPV as intense expression of E6, Ki-67 (P = 0.013, P = 0.055) has except for the expression of telomerase present a non-significant association (P<0.341).
  
  
  CONCLUSIONS
  Overexpression of E6 and Ki-67 is associated with the integration of HPV-16, favoring viral persistence, and increasing the risk of progression in women with NSIL and LSIL.
authors.affiliation: Laboratory for Research in Cytopathology and Histoquemical, Guerrero, México.
authors.forename: Arianna
authors.initials: A
authors.lastname: Vega-Peña
authors.affiliation: Laboratory for Molecular Biomedicine, Guerrero, México.
authors.forename: Berenice
authors.initials: B
authors.lastname: Illades-Aguiar
authors.affiliation: Laboratory for Chronic-Degenerative Diseases, Guerrero, México.
authors.forename: Eugenia
authors.initials: E
authors.lastname: Flores-Alfaro
authors.affiliation: Department of Genetics and Molecular Biology, CINVESTAV (Center for Research and Advanced Studies of the National Polytechnic Institute), DF, México.
authors.forename: Esther
authors.initials: E
authors.lastname: López-Bayghen
authors.affiliation: Laboratory for Molecular Biomedicine, Guerrero, México.
authors.forename: Marco Antonio
authors.initials: MA
authors.lastname: Leyva-Vázquez
authors.affiliation: Laboratory for Cancer Cellular Biology, Academic Unit for Chemical Biological Sciences, Autonomous University of Guerrero, Chilpancingo, Guerrero, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Castañeda-Saucedo
authors.affiliation: Laboratory for Research in Cytopathology and Histoquemical, Guerrero, México.
authors.forename: Luz Del Carmen
authors.initials: Ldel C
authors.lastname: Alarcón-Romero
keywords: Cervical lesions; E6; HPV-16; Ki-67; integration; telomerase