Sharma Bhawna, Lakhanpal Vikas, Singh Kanwardeep, Oberoi Loveena, Bedi Preet Kamal, Devi Pushpa
Department of Microbiology, Government Medical College, Amritsar, Punjab, India.
Department of Internal Medicine, Government Medical College, Amritsar, Punjab, India.
J Lab Physicians. 2022 Jul 4;14(3):336-342. doi: 10.1055/s-0042-1748919. eCollection 2022 Sep.
Human papillomavirus (HPV) E6/E7 mRNA tests determine the oncogenic activity of the virus and represent a good clinical biomarker for predicting the risk of cervical cancer. So, the present study was conducted to know the role of HPV E6/E7 mRNA as a predictive biomarker for cervical carcinoma. The present study was conducted on 55 clinical samples of cervical scrapings and biopsy from the clinically suspected cases (based on signs and symptoms) of cervical cancer having abnormal PAP smear. The samples were processed in three steps-(1) HPV DNA detection, (2) HPV E6/E7 mRNA detection, and (3) histopathological analysis. Out of a total of 55 patients, 16 (29.09%) were positive for both HPV E6/E7 mRNA and HPV DNA and six were positive for only HPV DNA. So, a total of 22 (40%) patients were positive for HPV DNA. Out of these 22 samples, 10 (45.5%) were of HPV-16, six (27.3%) were of HPV-18, four (18.2%) were of HPV-31, and two (9.1%) were of HPV-45. Out of total 16 patients positive for HPV E6/E7 mRNA, 10 (62.5%) were of genotype 16 and six (37.5%) were of genotype 18. The patients who were found positive for HPV 31 and 45 genotypes did not have E6/E7 mRNA expression. On colposcopic-guided biopsy, among these 16 samples, eight (50%) were diagnosed with invasive squamous cell carcinoma, six (37.5%) with cervical intraepithelial neoplasia grade 3 (CIN3), and two (12.5%) with CIN2. Out of those six patients in whom only HPV DNA was positive, five had normal biopsy findings and one had CIN1. The present study suggests that HPV E6/E7 mRNA detection could be more reliable than DNA testing for predicting the risk of progression of HPV-induced cervical lesions to cervical carcinoma and it can be used as a non-invasive tool for triage and patient follow-up.
人乳头瘤病毒（HPV）E6/E7 mRNA检测可确定该病毒的致癌活性，是预测宫颈癌风险的良好临床生物标志物。因此，本研究旨在了解HPV E6/E7 mRNA作为宫颈癌预测生物标志物的作用。
本研究对55例临床疑似宫颈癌（基于体征和症状）且巴氏涂片异常的宫颈刮片和活检临床样本进行了研究。样本经过三个步骤处理：（1）HPV DNA检测；（2）HPV E6/E7 mRNA检测；（3）组织病理学分析。
在总共55例患者中，16例（29.09%）HPV E6/E7 mRNA和HPV DNA均为阳性，6例仅HPV DNA为阳性。因此，共有22例（40%）患者HPV DNA为阳性。在这22个样本中，10例（45.5%）为HPV-16型，6例（27.3%）为HPV-18型，4例（18.2%）为HPV-31型，2例（9.1%）为HPV-45型。在HPV E6/E7 mRNA阳性的16例患者中，10例（62.5%）为16型基因型，6例（37.5%）为18型基因型。HPV 31和45基因型呈阳性的患者未检测到E6/E7 mRNA表达。在阴道镜引导下活检的这16个样本中，8例（50%）被诊断为浸润性鳞状细胞癌，6例（37.5%）为宫颈上皮内瘤变3级（CIN3），2例（12.5%）为CIN2。在仅HPV DNA阳性的6例患者中，5例活检结果正常，1例为CIN1。
本研究表明，对于预测HPV诱发的宫颈病变进展为宫颈癌的风险，HPV E6/E7 mRNA检测可能比DNA检测更可靠，并且可作为一种用于分流和患者随访的非侵入性工具。
