Nagandla Kavitha, Lin Khaw Huang, Chitra Ebenezer, Jamli Mohamed Faiz Bin Mohamed
Department of Obstetrics & Gynaecology, International Medical Unversity, Seremban, Malaysia.
International Medical University, Kuala Lampur, Malaysia.
Obstet Gynecol Sci. 2021 Sep;64(5):419-436. doi: 10.5468/ogs.21123. Epub 2021 Aug 13.
We performed a systematic review to identify the role of microRNAs (miRNAs) as biomarkers in the progression of cervical precancerous lesions. A comprehensive search of the Cochrane Controlled Register of Trials, PubMed, ScienceDirect, and Embase databases was performed for articles published between January 2010 and June 2020. The following Medical Subject Headings (MeSH) terms were searched: "microRNA" and "cervical" and "lesion." All study designs that aimed to evaluate the correlation of miRNA expression with different precancerous cervical staging and/or cervical cancer were included, except for case reports and case series. Approximately 82 individual miRNAs were found to be significant in differentiating the stages of cervical carcinogenesis. Among the miRNAs, miR-21 is the most prevalent, and it is consistently upregulated progressively from normal cervical to worsening cervical lesion stages in both cell and serum samples. miR-205 has been shown to have a higher specificity than human papilloma virus testing in predicting the absence of high-grade squamous intraepithelial lesions (HSILs) in exfoliated cell samples. The tumor suppressor miRNAs miR-34, let-7, miR-203 miR-29, and miR-375 were significantly downregulated in low-grade squamous intraepithelial lesions, HSILs, and cervical cancer. We found significant dysregulated miRNAs in cervical carcinogenesis with their dynamic expression changes and ability to detect viral persistency, risk prediction of low-grade lesions (cervical intraepithelial neoplasia [CIN] 2) to high-grade lesions (CIN 3), and progression of CIN 3 to cancer. Their ability to discriminate HSILs from non-dysplastic lesions has potential implications in early diagnosis and reducing overtreatment of otherwise regressive early preinvasive lesions.
我们进行了一项系统综述，以确定微小RNA（miRNA）作为生物标志物在宫颈癌前病变进展中的作用。对Cochrane对照试验注册库、PubMed、ScienceDirect和Embase数据库进行了全面检索，以查找2010年1月至2020年6月发表的文章。检索了以下医学主题词（MeSH）：“微小RNA”、“宫颈”和“病变”。除病例报告和病例系列外，纳入了所有旨在评估miRNA表达与不同宫颈癌前分期和/或宫颈癌相关性的研究设计。发现约82种个体miRNA在区分宫颈癌发生阶段方面具有显著意义。在这些miRNA中，miR-21最为普遍，在细胞和血清样本中，从正常宫颈到宫颈病变恶化阶段，其表达持续逐渐上调。在预测脱落细胞样本中无高级别鳞状上皮内病变（HSIL）方面，miR-205已被证明比人乳头瘤病毒检测具有更高的特异性。肿瘤抑制性miRNA miR-34、let-7、miR-203、miR-29和miR-375在低级别鳞状上皮内病变、HSIL和宫颈癌中显著下调。我们发现宫颈癌发生过程中存在显著失调的miRNA，它们具有动态表达变化以及检测病毒持续性、低级别病变（宫颈上皮内瘤变[CIN]2）到高级别病变（CIN 3）的风险预测以及CIN 3进展为癌症的能力。它们区分HSIL与非发育异常病变的能力在早期诊断以及减少原本可消退的早期浸润前病变的过度治疗方面具有潜在意义。
