Carcea Fausto, Daniilidis Angelos, Vavoulidis Eleftherios, Nasioutziki Maria, Papanikolaou Alexios, Dinas Konstantinos
Second Department of Obstetrics and Gynaecology, Medical Faculty, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece.
J BUON. 2020 Jan-Feb;25(1):99-107.
Our aim was to detect and evaluate potential alterations in the postoperative status of E6/E7 HPV mRNA in women treated for cervical intraepithelial lesions (CIN) and if so, to evaluate its potential use as a prognostic tool to identify patients with increased risk of treatment failure or recurrent disease.
Our study retrospectively analyzed 101 women with an abnormal Pap smear, or in some cases with histological reports or molecular analysis requiring colposcopic evaluation. Thin-prep cytological samples were collected before colposcopy and histology (when necessary). After treatment, all women were scheduled for colposcopy in six months. The cytological material was analyzed with CLART-2 HPV-DNA test and HPV-PROOFER E6/E7 mRNA test.
Concerning demographics, no significant correlations were found for smoking, condom use or vaccination status. It seems that the only statistically significant correlation with actual severity came from the mRNA-test after treatment. This shows that clinical cases with more severe CIN may have higher chances of unsuccessful treatment. At the first post-op visit, 83.5% of HPV mRNA-positive women had a negative HPV mRNA-test while only 60.4% of HPV DNA-positive women became negative. There were 12 HPV-mRNA positive patients both before and after treatment, 3 of whom had a negative HPV DNA test, meaning that, if based only on HPV-DNA results, they would have been managed wrongly as successfully treated patients. Our study shows that E6/E7 mRNA detection has particularly high specificity and positive likelihood ratio for the prediction of treatment failure in comparison with HPV DNA-testing.
E6/E7 mRNA overexpression seems to be a promising candidate as an indicator-biomarker to determine the success of treatment.
我们的目的是检测和评估接受宫颈上皮内瘤变（CIN）治疗的女性术后E6/E7人乳头瘤病毒（HPV）信使核糖核酸（mRNA）状态的潜在变化，如果存在变化，则评估其作为预后工具以识别治疗失败或疾病复发风险增加患者的潜在用途。
我们的研究回顾性分析了101例巴氏涂片异常的女性，或在某些情况下有需要阴道镜评估的组织学报告或分子分析结果的女性。在阴道镜检查和组织学检查（必要时）前收集薄层液基细胞学样本。治疗后，所有女性均安排在6个月后进行阴道镜检查。用CLART-2 HPV-DNA检测和HPV-PROOFER E6/E7 mRNA检测对细胞学材料进行分析。
关于人口统计学特征，未发现吸烟、使用避孕套或疫苗接种状况有显著相关性。似乎与实际严重程度唯一具有统计学显著相关性的是治疗后的mRNA检测。这表明CIN更严重的临床病例治疗失败的可能性可能更高。在术后首次随访时，83.5%的HPV mRNA阳性女性HPV mRNA检测结果为阴性，而HPV DNA阳性女性中只有60.4%转为阴性。治疗前后均有12例HPV-mRNA阳性患者，其中3例HPV DNA检测结果为阴性，这意味着，如果仅基于HPV-DNA结果，她们会被错误地判定为治疗成功。我们的研究表明，与HPV DNA检测相比，E6/E7 mRNA检测在预测治疗失败方面具有特别高的特异性和阳性似然比。
E6/E7 mRNA过表达似乎是一种很有前景的候选指标生物标志物，可用于确定治疗是否成功。
