Work

High-Grade Cervical Intraepithelial Neoplasia: Impact of Colposcopic Lesion Area on Systemic Immune Responses

Year: 2025

Type: article

Abstract: Background: The progression of high-grade cervical intraepithelial neoplasia (CIN) and cervical cancer is accompanied by a reduction in the immune response. The objectives of the study were to determine whether colposcopic lesion area is associated with serum levels of cytokines IL (interleukin) − 1, IL-6, IL-8, IL-10, IL-12 and TNF-α in precursor lesions of cervical cancer. Methods: The study population comprised patients with high-grade squamous intraepithelial lesion who had undergone colposcopy, cervical biopsy, and measurements of serum cytokines by ELISA (Enzyme-Linked Immunosorbent Assay ). Genotyping for HPV (human papillomavirus) 16, 18, 45 and 52 was performed by PCR ( Polymerase Chain Reaction ). ROC ( Receiver Operating Characteristic ) curves were calculated to determine whether there existed a cut-off value for serum cytokines in patients with colposcopic lesion area smaller vs larger than 1 cm 2 . For cytokines with significant results, these cut-off values were used to perform the multivariable analysis. Results: There were 71 patients with CIN 2/3. ROC curves were calculated to verify a cut-off value for serum cytokine levels that could be used to distinguish between lesion areas < 1 cm2 vs ≥ 1 cm2. Values with statistical significance were IL-1 > 13.3 pg/mL and IL-12 ≤ 349.6 pg/mL. In the multivariable analysis, the independent variables associated with colposcopic lesion area greater than 1cm 2 were IL-1> 13.3 pg/mL and IL-12 ≤ 349.6 pg/mL [OR (95% CI) = 10.10 (1.50– 67.96); OR (95% CI)=10.70 (1.17– 97.45), respectively]. Conclusion: Although CIN 2/3 is a local uterine cervix lesion, there is a systemic immunological response. Our results are unprecedented and could be the target of new important studies in public health and cervical cancer prevention. Keywords: uterine cervical dysplasia, cytokines, uterine cervical neoplasms

Source: International Journal of Women s Health

DOI: 10.2147/ijwh.s503028