Predictive value of HPV E6/E7 mRNA for the outcome of cervical intraepithelial neoplasia grade 1

Abstract:

Objective To evaluate the application value of human papilloma virus（HPV） E6/E7 mRNA in predicting the outcome of cervical intraepithelial neoplasia grade Ⅰ（CIN Ⅰ）.Methods From October 2017 to March 2020， a total of 208 patients admitted to the Outpatient Department of Chongqing Health Center for Women and Children with abnormalities in one of the results of thinprep cytology test（TCT）， HPV DNA and HPV E6/E7 mRNA tests and then diagnosed as CIN Ⅰby colposcopy were randomly selected. A year later， these patients were retested of TCT， HPV DNA and HPV E6/E7 mRNA tests. Cervical biopsy was performed through colposcopy again for one abnormal result. Patients were followed up for regression，persistence， or progression of the lesion. It was in this way that we tried to analyze the predictive value of HPV E6/E7 mRNA for the risk of progression of CIN Ⅰ.Results ①Among the 208 patients with CIN Ⅰ，17 patients progressed to CIN Ⅱ or CINI Ⅲ， with progression rate of 8.2%. The positive rate of TCT was 58.8%，and the positive rate of both HPV DNA and HPV E6/E7 mRNA was 100% in patients with progression. ②The hazard ratio（HR） value of TCT，HPV DNA，and HPV E6/E7 mRNA in the Cox regression analysis was 9.184， 158.675，and 293.650， respectively. The HR value of HPV E6/E7 mRNA was the highest，indicating that HPV E6/E7 mRNA had the greatest predictive value for CIN Ⅰ progression. ③HPV DNA and HPV E6/E7 mRNA had the highest sensitivity. TCT had the highest specificity，followed by the HPV E6/E7 mRNA. HPV DNA had poor specificity. Thus，HPV E6/E7 mRNA had both the highest sensitivity and high specificity. ④The area under the curve（AUC） value of TCT，HPV DNA，and HPV E6/E7 mRNA in the ROC curve was 0.633，0.427，and 0.772，respectively. The AUC value of HPV E6/E7 mRNA was the highest，indicating that HPV E6/E7 mRNA had the greatest diagnostic value for CIN Ⅰ progression. The AUC value of HPV DNA combined with HPV E6/E7 mRNA，HPV DNA combined with TCT，and HPV E6/E7 mRNA combined with TCT in the ROC curve was 0.777，0.728， and 0.839， respectively. The AUC value of HPV E6/E7 mRNA combined with TCT was the highest， indicating that HPV E6/E7 mRNA combined with TCT had the greatest diagnostic value for CIN Ⅰ progression.Conclusion The HPV E6/E7 mRNA test has certain significance in predicting the outcome of CIN Ⅰ，which can be used for the follow-up shunt management of CIN Ⅰ，and is worthy of clinical promotion and application.