The article below summarizes a roundtable discussion of a study published in this issue of the Journal in light of its methodology, relevance to practice, and implications for future research. Article discussed:
Lin CJ, Lai H-C, Wang KH, et al. Testing for methylated PCDH10 or WT1 is superior to the HPV test in detecting severe neoplasms (CIN3 or greater) in the triage of ASC-US smear results. Am J Obstet Gynecol 2011;204:21.e1-7.
The full discussion appears at www.AJOG.org , pages e12-3.
Discussion Questions
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What is the research question?
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Can you briefly explain epigenetics?
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What do you think of the researchers’ choice of biomarkers?
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How would you describe the overall study design?
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What were the main results of the study?
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Can you comment on the strengths and weaknesses of this study?
In clinical practice, an appreciable percentage of Pap smears are found to contain atypical squamous cells of undetermined significance (ASC-US). Management of patients with these results is controversial because while such findings are generally not of immediate concern, a minority of women go on to develop cervical intraepithelial neoplasms and a tiny fraction already have invasive lesions that have yet to be picked up. In a new study, Lin and colleagues compared testing for methylation of several specific promoter regions on a trio of tumor suppressor genes with traditional human papillomavirus (HPV) testing in predicting lesions among women with ASC-US Pap smears.
See related article, page 21
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