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Human papillomavirus (HPV) E6/E7 mRNA detection in cervical exfoliated cells: a potential triage for HPV-positive women

宫颈脱落细胞人乳头瘤病毒(HPV)E6/E7 mRNA检测在HPV 阳性女性筛查中的应用

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Abstract

Cytology triage has been generally recommended for human papillomavirus (HPV)-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou (Pap) test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus® HPV E6/E7 mRNA assay in cervical exfoliated cells. All HPV-positive women underwent colposcopy and further biopsy if indicated. The data were assessed by Pearson’s Chi-squared test and the receiver operating characteristic curve. A total of 404 eligible HPV-positive women were enrolled. Positive rate of E6/E7 mRNA in high-grade squamous intraepithelial lesion (HSIL) cases was higher than that in low-grade squamous intraepithelial lesion (LSIL) or normal cases. There was no statistical difference found between mRNA and cytological testing with sensitivity (89.52% vs. 86.67%, P=0.671), specificity (48.96% vs. 48.96%, P=1.000), positive predictive value (39.00% vs. 38.24%, P=1.000), and negative predictive value (92.76% vs. 90.97%, P=0.678) for detecting ≥HSIL. HPV E6/E7 mRNA detection in cervical exfoliated cells shows the same performance as Pap triage for HSIL identification for HPV-positive women. Detection of HPV E6/E7 mRNA may be used as a new triage option for HPV-positive women.

概要

目的

基于临床样本探讨宫颈脱落细胞HPV E6/E7mRNA检测能否作为HPV阳性女性的筛查手段。

创新点

首次比较了宫颈脱落细胞HPV E6/E7 mRNA 检测与宫颈脱落细胞学检测对于HPV 阳性女性宫颈活检结果的预测价值。

方法

所有入组的HPV 阳性女性均进行宫颈脱落细胞学及HPV E6/E7 mRNA 检测。比较两种方法对于宫颈活检结果的预测价值。

结论

对于HPV 阳性的女性,高级别鳞状上皮内病变(HSIL)HPV E6/E7 mRNA 阳性率高于低级别鳞状上皮内病变(LSIL)及正常病例。HPV E6/E7mRNA 与细胞学检测相比,HSIL 及以上级别病变的检测敏感性(89.52% vs. 86.67%,P=0.671)、特异性(48.96% vs. 48.96%,P=1.000)、阳性预测值(39.00% vs. 38.24%,P=1.000)及阴性预测值(92.76% vs. 90.97%,P=0.678)均无显著差异。HPV E6/E7 mRNA 检测或能成为HPV阳性女性的一种新的筛查手段。

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Authors and Affiliations

  1. Department of Gynecologic Oncology, Women’s Hospital, School of Medicine, Zhejiang University, Hangzhou, 310006, China

    Ye-li Yao, Qi-fang Tian, Bei Cheng, Yi-fan Cheng, Jing Ye & Wei-guo Lu

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  1. Ye-li Yao
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  2. Qi-fang Tian
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  3. Bei Cheng
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  4. Yi-fan Cheng
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  5. Jing Ye
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  6. Wei-guo Lu
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Corresponding authors

Correspondence to Ye-li Yao or Wei-guo Lu.

Additional information

Project supported by the Special Fund for Scientific Research in the Public Interest from the National Health and Family Planning Commission of the People’s Republic of China (No. 201402010), the National Key Technology R & D Program of China (No. 2016YFC1302900), the Zhejiang Provincial Educational Project (No. Y201328819), the Zhejiang Provincial Medical & Hygienic Science and Technology Project (Nos. 2013KYB147 and 2013KYA104), and the Zhejiang Provincial Natural Science Foundation (No. LQ14H160007), China

ORCID: Ye-li YAO, http://orcid.org/0000-0003-4014-4052

Compliance with ethics guidelines

Ye-li YAO, Qi-fang TIAN, Bei CHENG, Yi-fan CHENG, Jing YE, and Wei-guo LU declare that they have no conflict of interest.

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5). Informed consent was obtained from all patients for being included in the study.

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Yao, Yl., Tian, Qf., Cheng, B. et al. Human papillomavirus (HPV) E6/E7 mRNA detection in cervical exfoliated cells: a potential triage for HPV-positive women. J. Zhejiang Univ. Sci. B 18, 256–262 (2017). https://doi.org/10.1631/jzus.B1600288

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  • DOI: https://doi.org/10.1631/jzus.B1600288

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