The natural history of high-grade
cervical intraepithelial neoplasia (CIN) is largely unpredictable and current histopathological examination is unable to differentiate between lesions that will regress and those that will not. Therefore, most high-grade lesions are currently treated by surgical excision, leading to overtreatment and unnecessary complications. Prognostic
biomarkers may differentiate between lesions that will regress and those that will not, making individualized treatment of high-grade CIN possible. This review identifies several promising prognostic
biomarkers. These
biomarkers include viral genotype and
viral DNA methylation (viral factors),
human leukocyte antigen-subtypes, markers of lymphoproliferative response,
telomerase amplification and human papillomavirus-induced epigenetic effects (host factors) and Ki-67, p53 and pRb (cellular factors). All identified
biomarkers were evaluated according to their role in the natural history of high-grade CIN and according to established criteria for evaluation of
biomarkers (prospective-specimen-collection, retrospective-blinded-evaluation [PROBE] criteria). None of the
biomarkers meets the PROBE criteria for clinical applicability and more research on prognostic
biomarkers in high-grade CIN is necessary.