Objective
Cervical intraepithelial neoplasia grades 2-3 (CIN2-3) are usually treated by cone excision, although only 30 % progress to cancer and 6-50 % regress spontaneously. Biomarkers predicting CIN2-3 regression would be of great clinical value and could reduce unnecessary cone excision and associated complications. The aim of this study was to investigate whether punch-biopsy derived immunohistochemical biomarkers, local immune response, CIN lesion size and condom use are independently correlated to regression of CIN2-3.
Methods
A prospective population-based cohort study of 162 women aged 25-40, with first-time onset diagnosis of CIN2-3 in colposcopy-directed biopsies was carried out. The median biopsy-cone interval was 16 weeks. Regression was defined as CIN1 or less in the cone biopsy.
Results
The regression rate was 21 % (34/162). pRb > 30 % in the lower epithelial half was the strongest predictor for regression (30 % regression, p < 0.0001). If additionally a CIN-lesion was smaller than 2.5 mm and CD4 + lymphoid cells in the subepithelial stroma ¡Ü 195 per 1.04 mm basal membrane, the regression rate was 53 % . In CIN-lesions > 2.5 mm and CD4 + ? stroma ¡Ü 195, consistent condom use increased the regression rate from 13 % to 67 % (p = 0.003). If pRb was ¡Ü 30 % , the regression rate was low (6 % ).
Conclusion
Biomarkers and CIN lesion length can predict CIN2-3 regression, and might be helpful to identify patients who can increase the regression rate of CIN lesions by consistent condom use.
