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L1 Gene Methylation in High-Risk Human Papillomaviruses for the Prognosis of Cervical Intraepithelial Neoplasia
  1. Noriko Oka, MS*,,
  2. Masahiro Kajita, PhD,
  3. Ryuichiro Nishimura, MD§,
  4. Chiho Ohbayashi, MD and
  5. Tamotsu Sudo, MD, PhD*,§
  1. *Section of Translational Research, Hyogo Cancer Center, Akashi;
  2. Central Research Laboratories, Sysmex Corporation, Kobe;
  3. Laboratory of Molecular Pharmaceutics and Technology, Faculty of Pharmacy, Takasaki University of Health and Welfare, Takasaki;
  4. §Department of Gynecologic Oncology, Hyogo Cancer Center, Akashi; and
  5. Division of Diagnostic Pathology, Kobe University Hospital, Kobe, Japan.
  1. Address correspondence and reprint requests to Tamotsu Sudo, MD, PhD, Section of Translational Research and Department of Gynecologic Oncology, Hyogo Cancer Center, 13-70 Kita-Oji, Akashi, Hyogo 673-8558, Japan. E-mail:


Objective The purpose of this study was to investigate the clinical significance of DNA methylation of the human papillomavirus (HPV) genome as a prognostic biomarker for cervical intraepithelial neoplasia (CIN).

Methods and Materials Clinical samples (paraffin-embedded tissues obtained by conization/hysterectomy or initial punch biopsy) were collected from patients at the Gynecologic Oncology of the Hyogo Cancer Center with informed consent. We evaluated the methylation status of the L1 gene of the HPV genome by bisulfite sequencing, calculating the methylation ratio (L1MR) as (number of methylated CpGs in the analyzed region of the L1 gene) / (number of all CpGs in the analyzed region of the L1 gene) × 100. The methylation analysis and in situ hybridization were performed with serial tissue-section slices.

Results DNA methylation was observed in the L1 gene, but not in the long control region of HPV-16, -18, or the other high-risk HPV types including HPV-31, -52, and -58. L1MR was associated with the CIN grade; the median L1MR was 2.3%, 11.2%, 35.2%, and 50.0% for CIN1, CIN2, CIN3, and squamous cell carcinoma, respectively. L1MRs also seemed to indicate physical status (integrated or episomal form) of the HPV genome in the host cell. L1MR of the progression group was significantly higher than that of the regression group.

Conclusions L1MR was associated with the CIN grade and indicated the HPV genome status in the host cell: high L1MR indicated HPV genome integration linked to progression from early-stage CINs, whereas low L1MR indicated an episomal HPV genome location in host cells. L1MR may be a prognostic indicator of CIN.

  • Cervical cancer
  • Cervical intraepithelial neoplasia
  • Human papillomavirus
  • L1 gene
  • Methylation

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  • Noriko Oka is an employee of Sysmex Corporation.

  • Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal’s Web site (

  • The authors declare no conflicts of interest