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However, the immune microenvironment that distinguishes progression from persistent or regressing lesions has not been well defined.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 69 patients under the age of 25 with high-risk HPV-positive cytology and biopsy-confirmed p16-positive CIN2 were included in the study. Biopsies were stained using 20 antibodies to a range of immune markers. Based on a 2-year follow-up, samples were analysed in \u201cprogressor\u201d (CIN3\u2009+) or \u201cpersister\/regressor\u201d (CIN1, 2 or normal) groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Progression was most strongly associated with Blimp-1 positive cell staining in the lesion (<jats:italic>P<\/jats:italic>\u2009=\u20090.0019) and with low numbers of infiltrating CD4 cells in the dermal region beneath the lesion (<jats:italic>P<\/jats:italic>\u2009=\u20090.0022). The presence of CD4, CD8 and T bet-positive cells in the dermal region most strongly correlated with CD11c cells in the persister\/regressor but not the progressor group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>High numbers of Blimp-1\u2009+\u2009cells in CIN2 lesions may predict progression to more severe disease. Measurement of Blimp-1 may have diagnostic utility for the determination of the need to treat women with cervical pre-cancer.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p>CIN2 progression is associated with high numbers of\u00a0Blimp-1 positive cells in the lesion. Detection of Blimp-1 in the lesion may have utility as a prognostic test to inform the need to treat CIN2.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00432-022-03993-4","type":"journal-article","created":{"date-parts":[[2022,4,6]],"date-time":"2022-04-06T17:04:07Z","timestamp":1649264647000},"page":"1991-2002","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Blimp-1 is a prognostic indicator for progression of cervical intraepithelial neoplasia grade 2"],"prefix":"10.1007","volume":"148","author":[{"given":"Mayumi","family":"Saito","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aarthi","family":"Rajesh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carrie","family":"Innes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachael","family":"van der Griend","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Fitzgerald","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bryony","family":"Simcock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Sykes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7918-613X","authenticated-orcid":false,"given":"Merilyn","family":"Hibma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,4,6]]},"reference":[{"key":"3993_CR1","doi-asserted-by":"publisher","first-page":"a1343","DOI":"10.1136\/bmj.a1343","volume":"337","author":"S Albrechtsen","year":"2008","unstructured":"Albrechtsen S, Rasmussen S, Thoresen S, Irgens LM, Iversen OE (2008) Pregnancy outcome in women before and after cervical conisation: population based cohort study. 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The funders had no role in the design of the study; in the collection, analyses, or interpretation of the data; in the writing of the manuscript, or the decision to publish the results.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"This study was part of a larger multicentre trial (ANZCTR number ACTRN12611000547943), approved on April 14, 2010, by the Multi-region Ethics Committee (Ethics reference: MEC\/09\/07\/079). Informed consent was obtained from all individual participants included in the study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}}]}}