Correlation Between Expression Level Of Human Papillomavirus E6E7 MRNA And Pathological Grades Of Cervical Lesions

Objective:This study detected the expression of human papillomavirus(HPV)E6E7 m RNA in patients with suspected cervical lesions,and compared with the results of histopathological diagnosis,to investigate the correlation between expression level of human papillomavirus E6E7 m RNA and pathological grades of cervical diseases.Methods : Between January 2016 and December 2016,300 outpatients in the Qingdao Municipal Hospital received liquid based thinprep test(TCT),and the cast-off from cervical orifice canals were collected for HPV typing detection and quantitative detection of E6E7 m RNA.Multiple punch biopsy of cervix was performed under colposcope.The patients with CINI and above were treated with surgical treatment。All operative patients were followed up for 3-6 months,12 months after operation,HPV typing detection and quantitative detection of E6E7 m RNA were performed respectively.The patients with high risk of HPV positive or HPV E6E7 m RNA positive were evaluated by colposcopy and pathological diagnosis of tissue biopsy.The patients with HPV positive or HPV E6E7 m RNA positive were performed colposcopy evaluation and pathological diagnosis of tissue biopsy again.Results:A total of 16 genotypes of high risk HPV were detected.The top five of the highest detection rates were HPV16,HPV18,HPV58,HPV52 and HPV31,respectively.The positive rate of type HPV16 and type 18 increased along with the pathological grade of cervical lesions.The positive rates of HPV E6E7 m RNA are different in different age groups,the difference was statistically significant(P <0.05);There were significant differences in the expression level of HPV E6E7 m RNA between different pathological grades of cervical lesions(H=151.859,(P <0.05).The expression level of HPV E6E7 m RNA positively correlated with pathological grades of cervical lesions.(r=0.630,(P <0.05);The positive rates of HPV E6E7 m RNA and HPV typing test are increased gradually with the progression of cervical lesions,but there was no significant difference between the positive rates of the two groups(P >0.05);The overall detection rate of E6E7 m RNA in patients with multiple infection of HPV was higher than those with HPV single infection.In patients with high level cervical lesions,the positive rate of HPV E6E7 m RNA in multiple infection patients was significantly higher than those in singleinfection patients,the difference between them was statistically significant(P<0.05);Up to 12 months follow-up period,21 cases of CIN residual/relapse and 1 cases of recurrent cervical cancer were detected.Quantitative detection of HPV E6E7 m RNA showed better specificity and positive predictive value of finding residual/recurrent lesions in CIN patients than those in HPV typing test,the difference between them was statistically significant(P < 0.05).Conclusion:1.The expression level of HPV E6E7 m RNA increased with the pathological grades of cervical lesions.2.Multiple infection of HPV may increase the risk of cervical cancer.3.The quantitative detection of HPV E6E7 m RNA has high specificity and low sensitivity,while the sensitivity of HPV typing is high.Combined the two detection methods may improve the diagnostic accuracy and detection rate of residual or recurrence after operation,and avoid missed diagnosis.