Huang Fanwei, He Liang, Li Wei, Huang Xiaoyuan, Zhang Tao, Muaibati Munawaer, Zhou Hu, Chen Shimin, Yang Wenhui, Yang Fan, Zhuang Liang, Hu Ting
National Clinical Research Centre for Obstetrics and Gynaecology, Cancer Biology Research Centre (Key Laboratory of the Ministry of Education), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Department of Gynecology and Obstetrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Infect Agent Cancer. 2024 Aug 8;19(1):36. doi: 10.1186/s13027-024-00600-8.
This study aimed to investigate whether persistent human papillomavirus integration at the same loci (PHISL) before and after treatment can predict recurrent/residual disease in women with CIN2-3.
A total of 151 CIN2-3 women treated with conization between August 2020 and September 2021 were included. To investigate the precision of HPV integration, we further analyzed HPV integration-positive patients. Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), and the Youden index for predicting recurrence/residual disease were calculated.
Among the 151 enrolled CIN2-3 women, 56 were HPV integration-positive and 95 had HPV integration-negative results. Six (10.7%) experienced recurrence among 56 HPV integration-positive patients, which was more than those in HPV integration-negative patients (one patient, 1.1%). In the 56 HPV integration-positive patients, 12 had positive HPV results after treatment, seven had PHISL, and two had positive cone margin. Among the seven patients who tested with PHISL, six (85.7%) had residual/recurrent disease. PHISL was a prominent predictor of persistent/recurrent disease. The HPV test, the HPV integration test, and PHISL all had a sensitivity of 100% and a NPV of 100% for residual/recurrent disease. PHISL showed better specificity (98.0% vs. 82.0%, p = 0.005) and PPV (85.7% vs. 40.0%, p = 0.001) than the HPV test for predicting recurrence.
The HPV-integration-positive CIN2-3 women had much higher relapse rates than HPV-integration-negative CIN2-3 women. The findings indicate that PHISL derived from preoperative and postoperative HPV integration tests may be a precise biomarker for the identification of residual/recurrent CIN 2/3.
本研究旨在调查治疗前后人乳头瘤病毒在相同位点的持续整合（PHISL）是否可预测CIN2-3女性的复发/残留疾病。
纳入2020年8月至2021年9月间接受锥切术治疗的151例CIN2-3女性。为研究HPV整合的准确性，我们进一步分析了HPV整合阳性患者。计算预测复发/残留疾病的敏感性、特异性、阳性和阴性预测值（分别为PPV和NPV）以及约登指数。
在151例纳入研究的CIN2-3女性中，56例HPV整合阳性，95例HPV整合阴性。56例HPV整合阳性患者中有6例（10.7%）复发，高于HPV整合阴性患者（1例，1.1%）。在56例HPV整合阳性患者中，12例治疗后HPV结果为阳性，7例有PHISL，2例切缘阳性。在7例检测为PHISL的患者中，6例（85.7%）有残留/复发疾病。PHISL是持续性/复发性疾病的显著预测指标。HPV检测、HPV整合检测和PHISL对残留/复发疾病的敏感性均为100%，NPV均为100%。在预测复发方面，PHISL的特异性（98.0%对82.0%，p = 0.005）和PPV（85.7%对40.0%，p = 0.001）均优于HPV检测。
HPV整合阳性的CIN2-3女性的复发率远高于HPV整合阴性的CIN2-3女性。研究结果表明，术前和术后HPV整合检测得出的PHISL可能是识别残留/复发CIN 2/3的精确生物标志物。
