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      • Human papillomavirus L1 capsid protein and HPV test as a biomarker for cervical intraepithelial neoplasia 2+

        ( Ki Eun Young ),( Min Jong Song ),( Keun Ho Lee ),( Soo Yoyung Hur ),( Jong Sup Park ),( Jin Hwi Kim ),( Joo Hee Yoon ),( Dong Choon Park ),( Sung Jong Lee ) 대한산부인과학회 2018 대한산부인과학회 학술대회 Vol.104 No.-

        Objective: The aim of this study was to evaluate the risk for development of CIN2+ using immunocytochemical expression of human papillomavirus (HPV) L1 capsid protein in patients with atypical squamous cells of unknown significance (ASCUS), and low grade squamous intraepithelial lesions (LSIL) with high risk of HPV infection. Methods: Between January 2013 and March 2018, we performed immunocytochemistry of HPV L1 protein in 285 women with minor cytologic abnormality of uterine cervix (70 ASCUS, and 215 LSIL) with high risk HPV DNA infection. Cytoactiv HPV L1 screening set was used for detection of HPV L1 capsid protein in cervical cytology. The expression of HPV L1 capsid protein was evaluated by two pathologists independently. The risk for CIN2+ was calculated using results of immunocytochemistry and HPV DNA test. Akaike information criterion(AIK) and Schwarz criterion(SC) were used for a measure of the goodness fit of an estimated statistical model. Results: The risks of developing CIN2 were 6.9 folds higher in patients with HPV16 or 18 infection than in patients with non HPV 16 or 18 infection and negativity for HPV L1 capsid protein in the ASCUS group (odds ratio[OR] 6.9, 95% confidence interval [CI] 2.2-22.2, P=0.001) and 6.7 folds higher in the LSIL group(OR 6.7, 95% CI 2.5-18.3, P=0.0002) than in patients with non HPV 16 or 18 infection. Model comparison analysis revealed that combination of cytology, HPV capsid protein immunocytochemistry and HPV test demonstrated the highest prediction rate for CIN2 (Akaike information criterion[AIC]: 191.7,Schwarz criterion[SC]:206.3) Conclusion: In conclusion, women with ASCUS and LSIL, HPV L1 capsid protein negative, and HPV 16 or 18 infection showed significant relationship with CIN2+. The results of this study suggest that immunocytochemistry of HPV L1 protein can be used for prediction of CIN2+ in patients with ASCUS and LSIL with HPV 16 or 18 infection.

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