Cao Limei, He Ping, Yang Jun, Long Xin, Chen Yanqiu, Yan Li, Zhou Deping
Department of Obstetrics and Gynecology, Women and Children's Hospital of Chongqing Medical University, Chongqing 400000, China.
Evid Based Complement Alternat Med. 2022 Aug 8;2022:8747919. doi: 10.1155/2022/8747919. eCollection 2022.
. To assess the predictive worth of HPV E6/E7 mRNA detection in the outcome of the cervical low-grade squamous intraepithelial lesion (LSIL). From September 2017 to early September 2019, patients screened for high-risk HPV positive or abnormal cervical liquid-based cytology were retrospectively analyzed and diagnosed with LSIL by cervical biopsy were recruited. The independent influencing factors of the regression of LSIL lesions after follow-up were analyzed, and the outcome of LSIL was calculated. The results of the initial colposcopy in this study were CIN I, CIN II/P16-negative, CIN II/P16-positive, and CIN III. At the time of re-examination, LSIL patients had three outcomes: regression, persistence, and progression. In the two follow-ups, 330 patients were finally included, including 276 CIN I patients (group A) and 54 CIN II/P16-negative patients (group B). The positive rates of HPV E6/E7 mRNA in each group were 66.67% and 70.37% for A and B, respectively. The total positive rate of E6/E7 mRNA was 67.27%, and there was no significant difference between the two groups ( > 0.05). After 1 year follow-up, whether HPV E6/E7 mRNA regressed or was negative was associated with the outcome of LSIL-related lesions ( < 0.05). The regression or negative rate of HPV E6/E7 mRNA was 1.57 times higher than the progression rate of HPV E6/E7 mRNA-positive diagnosis of LSIL lesions. Univariate logistic regression analysis showed that age at first sexual intercourse, HPV E6/E7 mRNA results, and lesion type were statistically significant ( < 0.05). Whether HPV E6/E7 mRNA was negative (OR = 2.420, =0.001) and age at first sexual intercourse ≥20 years (OR = 0.420, =0.002) were independent influencing factors associated with LSIL regression. Multivariate logistic analysis showed that age of first sexual intercourse ≥20 years (OR = 0.420, =0.002) and HPV E6/E7 mRNA-negative (OR = 2.420, =0.001) were independent factors associated with LSIL. HPV E6/E7 mRNA detection can be used for predicting the outcome of LSIL and has a good application value.
评估HPV E6/E7 mRNA检测对宫颈低度鳞状上皮内病变（LSIL）转归的预测价值。回顾性分析2017年9月至2019年9月初筛查高危型HPV阳性或宫颈液基细胞学异常且经宫颈活检确诊为LSIL的患者。分析随访后LSIL病变消退的独立影响因素，并计算LSIL的转归情况。本研究初始阴道镜检查结果为CIN I、CIN II/P16阴性、CIN II/P16阳性和CIN III。复查时，LSIL患者有三种转归情况：消退、持续和进展。在两次随访中，最终纳入330例患者，其中276例CIN I患者（A组）和54例CIN II/P16阴性患者（B组）。A、B两组HPV E6/E7 mRNA阳性率分别为66.67%和70.37%。E6/E7 mRNA总阳性率为67.27%，两组间差异无统计学意义（>0.05）。随访1年后，HPV E6/E7 mRNA是否消退或为阴性与LSIL相关病变的转归有关（<0.05）。HPV E6/E7 mRNA的消退或阴性率比HPV E6/E7 mRNA阳性诊断的LSIL病变进展率高1.57倍。单因素logistic回归分析显示，初次性交年龄、HPV E6/E7 mRNA结果和病变类型具有统计学意义（<0.05）。HPV E6/E7 mRNA是否为阴性（OR = 2.420，=0.001）和初次性交年龄≥20岁（OR = 0.420，=0.002）是与LSIL消退相关的独立影响因素。多因素logistic分析显示，初次性交年龄≥20岁（OR = 0.420，=0.002）和HPV E6/E7 mRNA阴性（OR = 2.420，=0.001）是与LSIL相关的独立因素。HPV E6/E7 mRNA检测可用于预测LSIL的转归，具有良好的应用价值。
