title: High risk HPV in situ hybridization, p16 INK 4A, and survivin expressions in cervical carcinomas and intraepithelial neoplasms: evaluation of prognostic factors.
abstract: BACKGROUND
  Cervical carcinoma (CC) is one of the most important health problems of adult women in developing countries. CC is the second most common carcinoma of the women worldwide. Efficient screening and early therapeutic programmes are vital because of the higher burden of the disease.
  
  
  METHODS
  The authors included a total of 53 cases in this study. Distribution of diagnoses among cases was as follows: cervical intraepithelial neoplasm (CIN) (n=44), squamous cell carcinoma (SCC) (n=7), adenocarcinoma in situ (n=1), and condyloma accuminatum (n=l). Presence, density, and nuclear identification form of human papilloma virus (HPV) DNA in relation with host cell DNA were evaluated by in situ hybridization (ISH) and p16 and survivin by immunohistochem- ical methods (IHC).
  
  
  RESULTS
  The authors determined that the presence, density, and nuclear identification form of high risk HPV DNA had diagnostic and prognostic importance in CC and CIN (p < 0.05). p16 and survivin also had diagnostic significance. Since p16 and survivin expressions signalled progressive oncogenic events, p16 and survivin were persistent HPV markers (for p16, p < 0.001, for survivin p < 0.01). The authors determined that expressions, density, and prevalence of all three markers showed correlation with increasing CIN grade (for p 16, p < 0.001, for survivin, p < 0.01, for HPV, p = 0.002). The episomal pattern which is the independent visit of Hr HPV DNA to host cell DNA, signalled early HPV infection (p = 0.001). When it is integrated into host cell DNA, especially if HPV DNA signal intensity and prevalence increases, then this signal signifies persistent HPV infection (p = 0.001).
  
  
  CONCLUSIONS
  With the aid of these findings, the authors determined that HPV is infectious in CIN I and proliferative (neoplastic) in CIN II-CIN III lesions.
authors.affiliation: Taksim GOP Education and Research Hospital, Istanbul, Turkey.
authors.forename: F
authors.initials: F
authors.lastname: Demir
authors.forename: E
authors.initials: E
authors.lastname: Kimiloglu
authors.forename: A A
authors.initials: AA
authors.lastname: Igdem
authors.forename: Y T
authors.initials: YT
authors.lastname: Ayanoglu
authors.forename: N
authors.initials: N
authors.lastname: Erdogan
mesh_terms: D000328:Adult; D000368:Aged; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000032:analysis*; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D051034:Inhibitor of Apoptosis Proteins / Q000032:analysis*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D027383:Papillomaviridae / Q000235:genetics / Q000302:isolation & purification*; D011379:Prognosis; D012306:Risk; D000077022:Survivin; D002583:Uterine Cervical Neoplasms / Q000737:chemistry / Q000209:etiology* / Q000821:virology; D002578:Uterine Cervical Dysplasia / Q000737:chemistry / Q000209:etiology*
chemical_list: C107489:BIRC5 protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D004279:DNA, Viral; D051034:Inhibitor of Apoptosis Proteins; D000077022:Survivin