title: Positive Surgical Margin, HPV Persistence, and Expression of Both TPX2 and PD-L1 Are Associated with Persistence/Recurrence of Cervical Intraepithelial Neoplasia after Cervical Conization.
abstract: OBJECTIVE
  To determine the clinicopathologic and immunohistochemical predictors of the persistence/recurrence of cervical intraepithelial neoplasia (CIN) after cervical conization.
  
  
  METHODS
  Medical records of 502 patients who received cervical conization treatment of CIN between 2005 and 2012 were reviewed. The clinicopathologic parameters were analyzed using Cox hazard regression. Fifty patients with CIN persistence/recurrence were matched to 50 cases without CIN persistence/recurrence. These 100 cervical specimens were assessed for expression of insulin-like growth factor II messenger RNA (mRNA)-binding protein 3 (IMP3), targeting protein for xenopus kinesin-like protein 2 (TPX2), and programmed cell death-1 ligand-1 (PD-L1) using immunohistochemical staining.
  
  
  RESULTS
  Multivariate analysis found that the independent predictors of CIN persistence/recurrence were positive surgical margin (hazard ratio 5.777, 95% confidence interval 2.334-14.301, p < 0.001) and human papilloma virus persistence for 6 months (hazard ratio 20.685, 95% confidence interval 7.350-57.657, p < 0.001). Co-expression of TPX2 and PD-L1 was significantly higher in CIN persistence/recurrence group than the group without CIN persistence/recurrence (p = 0.013). The depth of glandular involvement (GI) was less than 3mm in about 86.8% (59/68) CIN2-3 lesions, However, No statistically significant associations between GI and persistence/recurrence were observed (P = 0.58).
  
  
  CONCLUSIONS
  Positive surgical margin, HPV persistence, and expression of both TPX2 and PD-L1 are associated with persistence/recurrence of cervical intraepithelial neoplasia after cervical conization.
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China.|Department of Obstetrics and Gynecology, Affiliated Hospital of Taishan Medical College, Taian, Shandong, China.
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Pathology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
authors.forename: Tingguo
authors.initials: T
authors.lastname: Zhang
authors.affiliation: Department of Structural & Cellular Biology, Tulane University, New Orleans, Louisiana, United States of America.|Department of Orthopaedic Surgery, Tulane University, New Orleans, Louisiana, United States of America.|Tulane Cancer Center and Louisiana Cancer Research Consortium, Tulane University, New Orleans, Louisiana, United States of America.|Tulane Center for Stem Cell Research and Regenerative Medicine, Tulane University, New Orleans, Louisiana, United States of America.|Tulane Center for Aging, Tulane University, New Orleans, Louisiana, United States of America.
authors.forename: Zongbing
authors.initials: Z
authors.lastname: You
authors.affiliation: Department of Obstetrics and Gynecology, Qilu Hospital of Shandong University, Jinan, Shandong, China.
authors.forename: Youzhong
authors.initials: Y
authors.lastname: Zhang
mesh_terms: D000328:Adult; D000368:Aged; D060890:B7-H1 Antigen / Q000378:metabolism*; D018797:Cell Cycle Proteins / Q000378:metabolism*; D049109:Cell Proliferation; D002584:Cervix Uteri / Q000473:pathology / Q000601:surgery*; D019092:Conization; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008869:Microtubule-Associated Proteins / Q000378:metabolism*; D008875:Middle Aged; D009687:Nuclear Proteins / Q000378:metabolism*; D027383:Papillomaviridae / Q000502:physiology*; D016601:RNA-Binding Proteins / Q000378:metabolism; D012008:Recurrence; D012306:Risk; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000378:metabolism / Q000473:pathology / Q000601:surgery / Q000821:virology*
chemical_list: D060890:B7-H1 Antigen; C423236:CD274 protein, human; D018797:Cell Cycle Proteins; C498780:IGF2BP3 protein, human; D008869:Microtubule-Associated Proteins; D009687:Nuclear Proteins; D016601:RNA-Binding Proteins; C122167:TPX2 protein, human