English (United Kingdom)

https://curated-unify.zendy.io/wp-json/zendy-region/v1/featured_content/oa?rat=en

https://curated-unify.zendy.io/wp-json/zendy-region/v1/highlighted_journal/

Zendy Plus

Presents the access of premium content as premium feature

Premium Content

Presents the keyphrase highlighting as premium feature

Keyphrase Highlighting

Presents the summarisation as premium feature

Summarisation

Insights

Presents the pdf analysis as premium feature

PDF Analysis

Presents the zaia usage as premium feature

ZAIA

Zendy Tools

Zendy Open

Summary   Objectives  Because current guidelines recognise high‐grade anal squamous intraepithelial lesions ( HSIL s) and low‐grade  SIL s ( LSIL s), and recommend treatment of all  HSIL s although not all progress to cancer, this study aims to distinguish transforming and productive  HSIL s by grading immunohistochemical ( IHC ) biomarkers p16  INK   4a  (p16) and E4 in low‐risk human papillomavirus (lr HPV ) and high‐risk (hr) HPV ‐associated  SIL s as a potential basis for more selective treatment.    Methods  Immunostaining for p16 and  HPV  E4 was performed and graded in 183 biopsies from 108  HIV ‐positive men who have sex with men. The causative  HPV  genotype of the worst lesion was identified using the  HPV SPF 10‐ PCR ‐ DEIA ‐Li PA 25 version 1 system, with laser capture microdissection for multiple infections. The worst lesions were scored for p16 (0–4) to identify activity of the hr HPV  E7 gene, and pan HPV  E4 (0–2) to mark  HPV  production and life cycle completion.    Results  There were 37 normal biopsies, 60  LSIL s and 86  HSIL s, with 85% of  LSIL s caused by lr HPV  and 93% of  HSIL s by hr HPV . No normal biopsy showed E4, but 43% of  LSIL s and 37% of  HSIL s were E4 positive. No differences in E4 positivity rates were found between lr HPV  and hr HPV  lesions. Most of the lesions caused by lr HPV  (90%) showed very extensive patchy p16 staining; p16 grade in  HSIL s was variable, with frequency of productive  HPV  infection dropping with increasing p16 grade.    Conclusions  Combined p16/E4  IHC  identifies productive and nonproductive  HSIL s associated with hr HPV  within the group of  HSIL s defined by the Lower Anogenital Squamous Terminology recommendations. This opens the possibility of investigating selective treatment of advanced transforming  HSIL s caused by hr HPV , and a ‘wait and see’ policy for productive  HSIL s.What's already known about this topic?For preventing anal cancer in high‐risk populations, all patients with high‐grade squamous intraepithelial lesions (HSILs) are treated, even though this group of lesions is heterogeneous, the histology is variable and regression is frequent.What does this study add?By adding human papillomavirus (HPV) E4 immunohistochemistry to p16  INK4a  (p16), and grading expression of both markers, different biomarker expression patterns that reflect the heterogeneity of HSILs can be identified.  Moreover, p16/E4 staining can separate high‐risk HPV‐associated HSILs into productive and more advanced transforming lesions, providing a potential basis for selective treatment.

british journal of dermatology

Grading immunohistochemical markers p16 INK4a  and HPV E4 identifies productive and transforming lesions caused by low‐ and high‐risk HPV within high‐grade anal squamous intraepithelial lesions