Evaluation of the Use of Methylation as a New Tool for the Diagnostics and Progression of Squamous Intraepithelial Lesions - academic paper

Sep 21, 2026

Vaccination against human papillomavirus (HPV) reduces HPV-related lesions, but clinicians still need reliable tools as patients present at younger ages and may require accurate confirmation and follow-up to prevent overtreatment. In women with histopathologically confirmed high-grade squamous intraepithelial lesions (HSIL), methylation testing helped identify lower-grade outcomes, including LSIL or no atypia. Among 108 Polish patients, negative methylation results were linked to ultimately diagnosing LSIL, suggesting reduced need for major cervical surgery. Future use may support precancer screening and lesion detection in the cervical canal.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Introduction

Background: HPV vaccination and cervical cancer burden

Study rationale for methylation testing

Clinical workflow and testing approach

Article Evaluation of the Use of Methylation as a New Tool for the Diagnostics and Progression of Squamous Intraepithelial Lesions Dominik Pruski 1, *, Sonja Millert-Kali ´nska 1,2, Agata Lis 3,4, Ewa Pelc 3,4, Przemysław Konopelski 3,4, Robert Jach 5 and Marcin Przybylski 1 Citation: Pruski, D.; Millert-Kali ´nska, S.; Lis, A.; Pelc, E.; Konopelski, P.; Jach, R.; Przybylski, M. Evaluation of the Use of Methylation as a New Tool for the Diagnostics and Progression of Squamous Intraepithelial Lesions. Int. J. Mol. Sci. 2024, 25, 11863. [https://](https://)[ ](https://)[doi.org/10.3390/ijms252211863](doi.org/10.3390/ijms252211863) Academic Editor: Marco Ciotti Received: 18 September 2024 Revised: 22 October 2024 Accepted: 28 October 2024 Published: 5 November 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://](https://)[ ](https://)[creativecommons.org/licenses/by/](creativecommons.org/licenses/by/)[ ](creativecommons.org/licenses/by/)[4.0/](4.0/)) . 1 Department of Obstetrics and Gynecology, District Public Hospital, Juraszów 7-19, 60-479 Poznan, Poland; [millertsonja@gmail.com](millertsonja@gmail.com) (S.M.-K.); [nicramp@poczta.onet.pl](nicramp@poczta.onet.pl) (M.P.) 2 Doctoral School, Poznan University of Medical Sciences, Fredry 10, 61-701 Poznan, Poland 3 Imogena Sp.z.o.o., ul. Jeleniogórska 16, 60-179 Poznan, Poland; [agata.lis@mineola.pl](agata.lis@mineola.pl) (A.L.); [ewa.pelc@gmail.com](ewa.pelc@gmail.com) (E.P.); [przemyslaw.konopelski@mineola.pl](przemyslaw.konopelski@mineola.pl) (P.K.) 4 Medical Diagnostic Laboratory Mineola, ul. Adama Vetulaniego 14, 31-226 Krakow, Poland 5 Division of Gynecologic Endocrinology, Jagiellonian University Medical College, Kopernika 23, 31-501 Krakow, Poland; [jach@cm-uj.krakow.pl](jach@cm-uj.krakow.pl) * Correspondence: [dominik.pruski@icloud.com](dominik.pruski@icloud.com) Abstract: Vaccination against human papillomavirus (HPV) significantly reduces the incidence of HPV-related lesions worldwide. Considering the increasingly young age of patients in gynecological offices and earlier sexual initiation and potential contact with the HPV virus, doctors need the tools to verify diagnoses. Currently, women plan to pursue motherhood later, so it is necessary to consider whether sexual treatment in the form of, among others, loop electrosurgical excision procedures (LEEPs) may increase the risk of premature birth or difficulty dilating the cervix during labour. For this reason, to avoid the overtreatment of low-grade squamous intraepithelial lesions (LSILs), methylation testing may be considered. In patients with histopathologically confirmed high-gradesquamous intraepithelial lesions (HSILs) during biopsy and, ultimately, a lower diagnosis, i.e., LSIL or no signs of atypia, methylation was found to be a useful tool. We performed a Pap smear, HPV genotyping, a punch biopsy, LEEP-conization (if needed), and methylation tests on 108 women admitted to the District Public Hospital in Poland. Women with a negative methylation test result were significantly more likely to be ultimately diagnosed with LSIL (p = 0.013) . This means that in 85.7% of the patients with HSIL, major cervical surgery could be avoided if the methylation test was negative. Methylation testing, as well as dual-staining and diagnostics detecting the mRNA transcripts of highly oncogenic types of HPV, might be used in the future in the diagnosis of precancerous conditions, mainly of the cervix, and in HPV-dependent cervical cancer screening. The methylation test may also be used in the diagnosis and identification of lesions within the cervical canal, including those located deep within the frontal crypts, not visible even during a professional colposcopic evaluation of the cervix. Keywords: methylation; risk of progression; o

FAQs

How might methylation testing be used in future cervical cancer screening?

It may be used alongside other approaches to diagnose precancerous conditions and to detect lesions within the cervical canal, including those not visible even during professional colposcopic evaluation.

Sep 21, 2026

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