Molecular prognostic and predictive factors in cervical cancer

Biomarker studies in preinvasive cervical disease and transition to invasive cancer are geared to understanding the biologic consequence of HPV infection in relation to clinically relevant cervical disease. There are two critical endpoints on the spectrum of cervical dysplasia. (Figure 18.2). The initial point (A) represents the cell at risk due to active HPV infection, whereas the second point (B) represents the clinically relevant preinvasive lesion, cervical intraepithelial neoplasia (CIN) 3 or carcinoma in situ (CIS).The latter lesion is the immediate precursor to invasive cervical cancer (C), and is the target for molecular diagnostic strategies, chemoprevention targeted at reversing aberrant molecular pathways in the preinvasive cells and vaccine strategies aimed at preventing the initiation step.The following sections will highlight some of the progress made in this translational science.