ABSTRACT
ABSTRACT Cervical cancer (CC) is one of the most common cancers in women worldwide and is caused by a persistent infection of certain human papillomavirus (HPV) genotypes. Although cytological examination using the Papanicolaou (Pap) test is considered the most cost-effective test for reducing CC mortality, a considerable number of high-grade precursor lesions of CC could pass unnoticed with the Pap. The addition of high-risk HPV genotype detection in cervical cytology has improved the sensitivity, but due to its low specicity, further biomarkers of malignancy have been searched for. The oncogenic role of HPV is exerted primary by affecting cell cycle control, and thus, most of the useful biomarkers of HPV-related uterine lesions are cell cycle proteins, being p16 and Ki-67 the most widely used. More recently, molecular proling and marker combination tests have identied the utility of antibody cocktails such as p16/Ki-67 dual and ProEx C, which detect both TOP2A and MCM2 cell cycle proteins. In this work we revise the rationale for the use of the most common biomarkers in cervical neoplasia and their clinical utility drawing attention to novel biomarkers and how HPV vaccination could inuence their use.
