Precancerous Cervical Lesions: Screening, Diagnosis and Clinical Practice

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: 20 March 2024 | Viewed by 1688

Special Issue Editors

Prof. Dr. Demetra Gabriela Socolov
E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: colposcopy; cervical cancer screening; cervical precancerous lesions; early diagnosis and conservative treatment; perinathology; obstetrical ultrasound
Prof. Dr. Liana Pleş
E-Mail Website
Guest Editor
Department of Obstetrics and Gynecology, “Carol Davila” University of Medicine and Pharmacy, 020021 Bucarest, Romania
Interests: colposcopy; cervical cancer screening; cervical precancerous lesions; early diagnosis and conservative treatment; perinathology; obstetrical ultrasound
Department of Morphofunctional Sciences I, ‘Grigore T. Popa’ University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: gynecologic and obstetric pathology; cervical cytology; carcinogenesis; immunohistochemistry; cDNA microarrays; digital pathology

Special Issue Information

Dear Colleagues,

The risk stratification of precancerous cervical lesions is a complex field of research that is undergoing constant improvement. With the introduction of multiple new and promising screening and diagnostic tests, we are now able to offer women an individualized risk profile and therapeutic management. There are multiple aims of this type of risk stratification, including the patients’ selection for colposcopy and cervical biopsy, choosing the best clinical conduct between follow-up and conservative cervical intervention, predicting the risk of residual lesions after conservative surgical management, and choosing the appropriate follow-up or surgical plans for such patients.

In order to fulfill these purposes, clinicians can use cytology and immunocytochemistry (Ki67, p16INK4a, p16/Ki-67 dual staining, ProExC including TOP2A (topoisomerase II α), MCM2 (minichromosome maintenance protein 2 expression) and other markers) or cell-block immunostaining, human papillomavirus (HPV) genotyping, cervical or vaginal microbiota, epigenomics, or specific markers (host cell gene metilation and molecular markers,) among other methods. Moreover, the inclusion of machine learning algorithms and artificial neural networks can improve the process of risk stratification by analyzing a large amount of complex data. This Special Issue on “Precancerous Cervical Lesions: Screening, Diagnosis and Clinical Practice” considers original research articles, review articles, commentaries and perspectives from all areas of precancerous cervical lesions research, risk stratification, and prediction.

Prof. Dr. Demetra Gabriela Socolov
Prof. Dr. Liana Pleş
Dr. Raluca Balan
Guest Editors

Manuscript Submission Information

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Keywords

  • cervical precancer
  • colposcopy
  • cervical cancer screening
  • risk stratification
  • HPV
  • vaginal microbiota
  • methylation markers
  • immunocytochemistry
  • artificial intelligence in colposcopy

Published Papers (2 papers)

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Research

14 pages, 2315 KiB  
Article
A Prospective Study on the Progression, Recurrence, and Regression of Cervical Lesions: Assessing Various Screening Approaches
J. Clin. Med. 2024, 13(5), 1368; https://doi.org/10.3390/jcm13051368 - 28 Feb 2024
Viewed by 172
Abstract
(1) Background: The prediction of cervical lesion evolution is a challenge for clinicians. This prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors in the prediction [...] Read more.
(1) Background: The prediction of cervical lesion evolution is a challenge for clinicians. This prospective study aimed to determine and compare the predictive accuracy of cytology, HPV genotyping, and p16/Ki67 dual staining alone or in combination with personal risk factors in the prediction of progression, regression, or persistence of cervical lesions in human papillomavirus (HPV)-infected patients; (2) Methods: This prospective study included HPV-positive patients with or without cervical lesions who underwent follow-up in a private clinic. We calculated the predictive performance of individual tests (cervical cytology, HPV genotyping, CINtecPlus results, and clinical risk factors) or their combination in the prediction of cervical lesion progression, regression, and persistence; (3) Results: The highest predictive performance for the progression of cervical lesions was achieved by a model comprising a Pap smear suggestive of high-grade squamous intraepithelial lesion (HSIL), the presence of 16/18 HPV strains, a positive p16/Ki67 dual staining result along with the presence of at least three clinical risk factors, which had a sensitivity (Se) of 74.42%, a specificity of 97.92%, an area under the receiver operating curve (AUC) of 0.961, and an accuracy of 90.65%. The prediction of cervical lesion regression or persistence was modest when using individual or combined tests; (4) Conclusions: Multiple testing or new biomarkers should be used to improve HPV-positive patient surveillance, especially for cervical lesion regression or persistence prediction. Full article
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20 pages, 3974 KiB  
Article
Exploring Microbiota Diversity in Cervical Lesion Progression and HPV Infection through 16S rRNA Gene Metagenomic Sequencing
J. Clin. Med. 2023, 12(15), 4979; https://doi.org/10.3390/jcm12154979 - 28 Jul 2023
Cited by 2 | Viewed by 1331
Abstract
(1) Background: Cervical cancer is a significant health concern, with the main cause being persistent infection with high-risk Human Papillomavirus (hrHPV). There is still no evidence for why viral persistence occurs in some women, but recent studies have revealed the interplay between cervical [...] Read more.
(1) Background: Cervical cancer is a significant health concern, with the main cause being persistent infection with high-risk Human Papillomavirus (hrHPV). There is still no evidence for why viral persistence occurs in some women, but recent studies have revealed the interplay between cervical microbiota and hrHPV. This research aimed to characterize the cervicovaginal microbiota in cervical lesion progression and HPV infection status. (2) Methods: This study included 85 cervical specimens from women from the north-eastern region of Romania. DNA was isolated from cervical secretion for HPV genotyping and 16S ribosomal RNA gene NGS sequencing. (3) Results: Our study revealed a distinct pattern within the studied group when considering Lactobacillus species, which differs from findings reported in other populations. Specifically, the presence of Lactobacillus iners coupled with the absence of Lactobacillus crispatus alongside Atopobium spp., Prevotella spp., and Gardnerella spp. could serve as defining factors for severe cervical lesions. The results also showed a significant association between microbiota diversity, HPV infection, and cervical lesion progression. (4) Conclusions: As the microbiota profile seems to vary among different populations and individuals, a deeper comprehension of its composition has the potential to develop personalized detection and treatment approaches for cervical dysplasia and cancer. Full article
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