The Value Of HPV E6/E7mRNA Test In The Accurate Screening Of Cervical Lesion

Background:Cervical cancer is the most common gynecological malignancy,Each year,there are about 528,000 women worldwide are attacked by cervical cancer,and about 266,000 women die of it.High-risk HPV(HR-HPV)is closely related to the occurrence of the majority of cervical intraepithelial neoplasia and cervical cancer.There is a long precancerous lesion period from initial HR-HPV infection to cervical cancer at last,about 10 to 15 years,which provides a good opportunity for cervical cancer screening.Therefore,finding a reasonable and effective screening method can early detect and treat precancerous lesions of cervical cancer,reduce the morbidity and mortality of cervical cancer.Given that progression of cervical cancer requires viral gene integration and over expression of E6 and E7 genes,the transcription of E6 and E7 may be useful markers of progress of the disease.HPV E6/E7 mRNA detection is a newly emerging cervical cancer screening method in recent years,and its advantages in cervical cancer screening remain to be studied.Purpose:Analysis the result of TCT,HR-HPV DNA and HPV E6/E7mRNA test of patients within 1 year before they are histopathological diagnosed with CINII+.Evaluate the application value of HPV E6/E7 mRNA detection in accurate cervical lesion screening.Materials and methods:1261 cases of CINII+ conformed by histopathology in the Shandong Provincial Hospital from January 2017 to May 2018 were enrolled in aretrospective analysis.Record and analysis the result of TCT,HR-HPV DNA and HPV E6/E7mRNA test within 1 year before the pathological diagnosis.ThinPrep-2000 automatic cell detector was used for TCT detection,ASCUS or ACG or above was positive for TCT detection,Cervista method was used for HR-HPV DNA test,Aptima method was used for HPV E6/E7 mRNA test.Result:1、The rate of missed diagnosis of TCT test,HR-HPV DNA test and HPV E6/E7mRNA test within 1 year before the pathological diagnosis were 11.90%(135/1134)、3.24%(25/772)、0.89%(3/337).The rate of missed diagnosis of HPV E6/E7mRNA test was significantly lower than that of TCT and HR-HPV DNA test.The difference among the three tests was statistically significant(P<0.05).2、The rate of missed diagnosis of HR-HPV DNA+TCT cotesting was 0.60%(3/663),was significantly lower than that of TCT and HR-HPV DNA test aloneThe difference was statistically significant(P<0.05).3、The rate of missed diagnosis of HPV E6/E7mRNA+TCT cotesting was 0%(0/296),was significantly lower than that of TCT test alone.The cdifference was statistically significant(P<0.05).But there was no statistically significant compared with HPV E6/E7mRNA test alone(P>0.05)Conclusion:1、When screening cervical lesions with a single method,HPV E6/E7 mRNA test has the lowest rate of missed diagnosis compared with TCT and HR-hHPV DNA test,indicating that HPV E6/E7 mRNA test has a high application value in accurate cervical lesion screening.2、Cotesting can reduce the missed diagnosis rate of single test.The missed diagnosis rate of HPV E6/E7mRNA+TCT cotesting is the lowest,but there is no statistical difference in the missed diagnosis rate compared with HPV E6/E7mRNA test alone.HPV E6/E7mRNA detection has a high application value in accurate cervical lesion screening and may become an effective means of cervical lesion screening.