{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T03:13:17Z","timestamp":1791342797218,"version":"4.3.1"},"reference-count":25,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T00:00:00Z","timestamp":1580860800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2020,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The decision to treat a cervical squamous intraepithelial lesion (SIL) by loop electrosurgical excision procedure (LEEP) relies heavily on a colposcopy\u2010directed biopsy showing high\u2010grade (H)SIL. Diagnosis is often supported by p16, an immunohistochemical (IHC) biomarker of high\u2010risk (hr)HPV E7 gene activity. Additional potential markers include methylation of tumor suppressor genes FAM19A4\/miR124\u20102 in cervical cytology for advanced transforming HSIL and the IHC marker HPV E4 for productive, potentially regressing lesions. In 318 women referred for colposcopy, we investigated the relationship between staining patterns of p16 and E4 IHC in the worst biopsy, and the relation of these to FAM19A4\/miR124\u20102 methylation status in cytology. E4\u2010positive staining decreased with increasing SIL\/CIN grade from 41% in LSIL to 3% in HSIL\/CIN3. E4 positivity increased with grade of p16 when p16 expression was limited to the lower two third of the epithelium (r\u00a0=\u00a00.378), but fell with expression over. Loss of E4 expression in the worst lesion was associated with the methylation of FAM19A4\/miR124\u20102. We also examined whether these biomarkers can predict the histological outcome of the LEEP biopsy in a subgroup of 119 who underwent LEEP treatment. About 85% of women with\u00a0\u2265lower two third p16 staining\/E4\u2010negative HSIL biopsies and 65% with limited p16 staining\/E4\u2010positive HSIL biopsies had\u00a0\u2265HSIL in the LEEP specimen (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.025). p16 expression in a biopsy is related both to viral production and transformation, while decreased E4 expression relates to methylation, indicating advanced HSIL. p16 expression in\u00a0\u22652\/3 of the epithelium and absent E4 indicate likely HSIL on a subsequent LEEP specimen.<\/jats:p>","DOI":"10.1002\/cam4.2855","type":"journal-article","created":{"date-parts":[[2020,2,5]],"date-time":"2020-02-05T12:39:55Z","timestamp":1580906395000},"page":"2454-2461","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Expression of p16 and HPV E4 on biopsy samples and methylation of FAM19A4 and miR124\u20102 on cervical cytology samples in the classification of cervical squamous intraepithelial lesions"],"prefix":"10.1002","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5882-7778","authenticated-orcid":false,"given":"Annemiek","family":"Leeman","sequence":"first","affiliation":[{"name":"DDL Diagnostic Laboratory Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Jenkins","sequence":"additional","affiliation":[{"name":"DDL Diagnostic Laboratory Rijswijk The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2178-2403","authenticated-orcid":false,"given":"Marta","family":"del Pino","sequence":"additional","affiliation":[{"name":"Institute of Gynecology, Obstetrics and Neonatology Hospital Cl\u00ednic\u2014Institut d\u00b4Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS), Faculty of Medicine\u2010University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaume","family":"Ordi","sequence":"additional","affiliation":[{"name":"Department of Pathology ISGlobal Hospital Clinic of Barcelona Universitat de Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aureli","family":"Torn\u00e9","sequence":"additional","affiliation":[{"name":"Institute of Gynecology, Obstetrics and Neonatology Hospital Cl\u00ednic\u2014Institut d\u00b4Investigacions Biom\u00e8diques August Pi I Sunyer (IDIBAPS), Faculty of Medicine\u2010University of Barcelona Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Doorbar","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Cambridge Cambridge United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris J. L. M.","family":"Meijer","sequence":"additional","affiliation":[{"name":"Amsterdam Medical Center Department of Pathology VU University Medical Centre Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Folkert J.","family":"van Kemenade","sequence":"additional","affiliation":[{"name":"Department of Pathology Erasmus University Medical Center Rotterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wim G. 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