title: Prognostic value of DNA and mRNA e6/e7 of human papillomavirus in the evolution of cervical intraepithelial neoplasia grade 2.
abstract: OBJECTIVE
  This study aimed at evaluating whether human papillomavirus (HPV) groups and E6/E7 mRNA of HPV 16, 18, 31, 33, and 45 are prognostic of cervical intraepithelial neoplasia (CIN) 2 outcome in women with a cervical smear showing a low-grade squamous intraepithelial lesion (LSIL).
  
  
  METHODS
  This cohort study included women with biopsy-confirmed CIN 2 who were followed up for 12 months, with cervical smear and colposcopy performed every three months.
  
  
  RESULTS
  Women with a negative or low-risk HPV status showed 100% CIN 2 regression. The CIN 2 regression rates at the 12-month follow-up were 69.4% for women with alpha-9 HPV versus 91.7% for other HPV species or HPV-negative status (P < 0.05). For women with HPV 16, the CIN 2 regression rate at the 12-month follow-up was 61.4% versus 89.5% for other HPV types or HPV-negative status (P < 0.05). The CIN 2 regression rate was 68.3% for women who tested positive for HPV E6/E7 mRNA versus 82.0% for the negative results, but this difference was not statistically significant.
  
  
  CONCLUSIONS
  The expectant management for women with biopsy-confirmed CIN 2 and previous cytological tests showing LSIL exhibited a very high rate of spontaneous regression. HPV 16 is associated with a higher CIN 2 progression rate than other HPV infections. HPV E6/E7 mRNA is not a prognostic marker of the CIN 2 clinical outcome, although this analysis cannot be considered conclusive. Given the small sample size, this study could be considered a pilot for future larger studies on the role of predictive markers of CIN 2 evolution.
authors.affiliation: Laboratory of Clinical Pathology and Cytology, Department of Clinical Chemistry and Toxicology, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil.
authors.forename: Michelle G
authors.initials: MG
authors.lastname: Discacciati
authors.affiliation: Department of Gynecology, Federal University of São Paulo, São Paulo, Brazil.
authors.forename: Ismael Dcg
authors.initials: ID
authors.lastname: da Silva
authors.affiliation: Laboratory of Virology, Ludwig Institute for Cancer Research, São Paulo, Brazil.
authors.forename: Luisa L
authors.initials: LL
authors.lastname: Villa
authors.affiliation: Department of Molecular Biology, Salomão & Zoppi Laboratory, São Paulo, Brazil.
authors.forename: Leandro
authors.initials: L
authors.lastname: Reis
authors.affiliation: Department of Molecular Biology, Salomão & Zoppi Laboratory, São Paulo, Brazil.
authors.forename: Priscila
authors.initials: P
authors.lastname: Hayashi
authors.affiliation: Laboratory of Virology, Ludwig Institute for Cancer Research, São Paulo, Brazil.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Costa
authors.affiliation: School of Pharmacy, Federal University of Goiás, Goiânia, Goiás, Brazil.
authors.forename: Silvia H
authors.initials: SH
authors.lastname: Rabelo-Santos
authors.affiliation: Department of Obstetrics and Gynecology, School of Medical Sciences, State University of Campinas, (UNICAMP), Campinas, São Paulo, Brazil.
authors.forename: Luiz C
authors.initials: LC
authors.lastname: Zeferino
keywords: E6 protein; cervical intraepithelial neoplasia; disease progression; human papillomavirus-16; neoplasm regression; papillomavirus E7 proteins; spontaneous; viral oncogene proteins