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E6/E7 mRNA型人乳头瘤病毒的过表达是宫颈上皮内瘤变3级患者接受宫颈环形电切术治疗后残余疾病进展的预后生物标志物。

Overexpression of E6/E7 mRNA HPV Is a Prognostic Biomarker for Residual Disease Progression in Women Undergoing LEEP for Cervical Intraepithelial Neoplasia 3.

作者信息

Bruno Maria Teresa, Bonanno Giulia, Sgalambro Francesco, Cavallaro Antonino, Boemi Sara

机构信息

Department of General Surgical and Medical-Surgery Specialities, University of Catania, 95124 Catania, Italy.

Multidisciplinary Research Center in Papillomavirus Pathology, University of Catania, 95124 Catania, Italy.

出版信息

Cancers (Basel). 2023 Aug 22;15(17):4203. doi: 10.3390/cancers15174203.

Abstract

The risk of overtreatment or not treating an occult carcinoma exists in women at risk of residual disease after a LEEP excision for CIN3. Our goal was to discover an efficient method to select patients requiring a second LEEP from those requiring a FU only through an mRNA-detection test. In a population of 686 women undergoing a LEEP excision for CIN 3, we selected 285 women at risk of residual disease and subjected them to a search for E6/E7 mRNA HPV. The women with negative mRNA were subjected to a follow up, while the women with positive mRNA were subjected to a second LEEP. The histological examination of the second cone revealed 120 (85.7%) cases of residual disease in the mRNA-positive women: 40 cases of CIN2, 51 cases of CIN3, 11 cases of squamous microinvasive carcinoma, 7 cases of squamous carcinoma, 9 cases of AIS (adenocarcinoma in situ) and 2 cases of adenocarcinoma. Among the mRNA-negative women undergoing a follow up, there were only five cases of residual disease. During the follow-up period of about 6 years, we witnessed the regression of the residual disease and the elimination of the virus, just as predicted by the negative result of the mRNA test. Testing patients for E6/E7 mRNA allowed us to identify women with residual disease (CIN2+) and treat them appropriately.

摘要

对于因CIN3接受LEEP切除术后有残留疾病风险的女性,存在过度治疗或未治疗隐匿性癌的风险。我们的目标是通过mRNA检测试验,找到一种有效的方法,从仅需要随访的患者中筛选出需要再次进行LEEP的患者。在686名因CIN 3接受LEEP切除的女性群体中,我们选择了285名有残留疾病风险的女性,并对她们进行E6/E7 mRNA HPV检测。mRNA检测结果为阴性的女性接受随访,而mRNA检测结果为阳性的女性则接受再次LEEP。对第二次锥切组织进行病理检查发现,mRNA检测结果为阳性的女性中有120例(85.7%)存在残留疾病:40例CIN2、51例CIN3、11例鳞状微浸润癌、7例鳞状细胞癌、9例原位腺癌(AIS)和2例腺癌。在接受随访的mRNA检测结果为阴性的女性中,只有5例存在残留疾病。在大约6年的随访期内,正如mRNA检测阴性结果所预测的那样,我们观察到残留疾病消退且病毒清除。对患者进行E6/E7 mRNA检测使我们能够识别出有残留疾病(CIN2+)的女性并对她们进行适当治疗。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6333/10487243/84f6446d0306/cancers-15-04203-g001.jpg

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