Tissue tumor marker expression in smokers, including serum cotinine concentrations, in women with cervical intraepithelial neoplasia or normal squamous cervical epithelium

Am J Obstet Gynecol. 2010 Jun;202(6):579.e1-7. doi: 10.1016/j.ajog.2009.11.034. Epub 2010 Jan 13.


Objective: The purpose of this study was to investigate correlations between smoking and serum cotinine, respectively, and tumor marker expression in cervical intraepithelial neoplasia (CIN) and normal epithelium.

Study design: Women (n = 228) with cervical biopsy specimens that ranged histologically from normal to carcinoma in situ (CIN III) were included. Expression of 11 tumor markers with possible relevance in cervical neoplasms was studied. Smoking habits were recorded, and serum was assessed for cotinine concentrations.

Results: No differences were found in tumor marker expression in normal epithelium between smokers and nonsmokers. The tumor suppressors p53 and fragile histidine triad and the immunologic marker interleukin-10 were underexpressed, and the tumor markers cyclooxygenase-2 and Ki-67 were overexpressed in smoking, compared with nonsmoking, women with CIN and particularly in all fertile women.

Conclusion: The molecular pattern indicates that smoking exerts unfavorable effects in cervical neoplasia. This provides biologic evidence of smoking being a true cofactor in cervical neoplasia.

MeSH terms

  • Acid Anhydride Hydrolases / metabolism
  • Adult
  • Biomarkers, Tumor / metabolism*
  • Cervix Uteri / metabolism*
  • Chi-Square Distribution
  • Cotinine / blood*
  • Epithelium / metabolism
  • Female
  • Humans
  • Immunohistochemistry
  • Interleukin-10 / metabolism
  • Middle Aged
  • Neoplasm Proteins / metabolism
  • Smoking*
  • Tumor Suppressor Protein p53 / metabolism
  • Uterine Cervical Dysplasia / metabolism*
  • Uterine Cervical Neoplasms / metabolism*


  • Biomarkers, Tumor
  • Neoplasm Proteins
  • Tumor Suppressor Protein p53
  • fragile histidine triad protein
  • Interleukin-10
  • Acid Anhydride Hydrolases
  • Cotinine