Nittaya Phanuphak, MD, PhD
Nominated From: University of Hawaii
Research Site: Thailand
Research Area: Biomarkers for Anal Intraepithelial Neoplasia
Primary Mentor: Dr. Jintanat Ananworanich (John A. Burns School of Medicine)
Anal Intraepithelial Neoplasia Biomarkers
This study will assess performance characteristics of biomarkers, including p16, high-risk HPV types, and E6 and E7 mRNA/oncoprotein in detecting high-grade anal intraepithelial neoplasia among a cohort of men who have sex with men in Bangkok and to study the impact of HIV infection on the characteristics of these biomarkers.
Anal intraepithelial neoplasia (AIN), especially high-grade AIN (HGAIN), is the putative precursor lesion for anal cancer. The incidence of anal cancer has increased sharply during the past decade, especially among men who have sex with men (MSM) and HIV-infected populations. The majority of new HIV cases in Thailand now are occurring among MSM population; the current HIV prevalence in MSM is approximately 30% in Bangkok and 10% in other big cities, compared to 1.4% in general population. With the rapidly increasing number of HIV cases among MSM in Thailand, the country is now facing with how best to screen and treat anal precancerous lesions among HIV-infected MSM. Currently, there are no standard guidelines for HGAIN screening, and most clinics are using anal Pap smear as the first screening test. Unfortunately, anal Pap smear alone has limited sensitivity and poor reliability as an indicator of the severity of AIN. Detection of cell cycle biomarkers such as p16, high-risk HPV infection, and E6 and E7 messenger RNA (mRNA)/oncoproteins of high-risk HPV may increase the sensitivity and specificity in identifying patients at high-risk for HGAIN who need more aggressive management.
Advice for Potential Applicants
The Fogarty Global Health Fellowship program offers real-life, mentored clinical research training experiences by highly-experienced researchers in the host country. Prioritizing research questions in the field you have dedicated to, with advice from your mentors, is an invaluable start of the whole cycle of research.