HPV DNA integration is correlated with persistence or progression of cervical intraepithelial neoplasia 2 (CIN2).

This study asks whether HPV-human DNA integrations found in CIN2 lesions are retained as lesions progress to cervical squamous cell carcinoma and whether detecting them at diagnosis can predict which lesions will persist or progress. Using multiplexed HPV hybridization capture and short-read sequencing, the authors found identical integrations preserved across serial samples in seven CIN lesions that became cancer, and detected integrations in 4 of 11 CIN2 cases that persisted or progressed versus none of 12 that regressed (p=0.04). Bayesian modeling estimated roughly 22-fold higher odds of persistence/progression with integration at baseline, suggesting integration status could help identify high-risk CIN2 lesions and reduce unnecessary excisions (given the small sample size, these findings warrant validation in larger cohorts).