Value Of HPV16 E7 Protein Detection In Diagnosis And Outcome Of Cervical Precancerous Lesions

Obiectve:To analyze the efficacy of HPV16 E7 protein detection in the diagnosis of cervical precancerous lesions and the risk assessment of the prognosis of different grades of cervical lesions caused by infection HPV16.Methods:1.Select 180 patients with HPV16-positive who were diagnosed with HSIL and below by pathology in the outpatient department of in Tianjin Central Obstetrics and Gynecology Hospital from September 2016 to December 2017.The clinical data got accounted and the cervical exfoliated cells were taken.The enzymatic chemiluminescence method was used to detect the concentration of HPV16 E7 protein.Using pathological diagnosis as the gold standard.The expression of HPV16E7 protein in different degrees of cytopathological results and histopathological test results was compared and the diagnostic efficacy of E7 protein in patients with normal TCT results was analyzed.2.Patients with histopathological diagnosis of LSIL and below or HSIL were followed up for 2 years.The patients were grouped according to the E7 protein.The different outcomes of patients with different E7 protein were compared to evaluate the value of E7 protein in clinical conversion of patients.At the same time,after a2-year follow-up of some patients with positive E7 protein,the cervical exfoliated cells were taken again to measure the expression of E7 protein and discuss the changes of E7 protein during the process of disease.Results:1.The positive rate and median expression(P25,P75)of E7 protein increased with NILM,ASCUS,ASCUS-H,LSIL,HSIL(P = 0.01),suggesting the positive rate and the expression load of HPV16 E7 protein was positively correlated with cervical cytopathology.2.The positive rate and median expression(P25,P75)of E7 protein increased with normal cervix,LSIL,and HSIL(P <0.001).The positive rate of E7 protein at LSIL and below was significantly lower than that in the HSIL group(P <0.001),suggesting that the positive rate and expression load of HPV16 E7 protein are positivelycorrelated with cervical histopathology and have a high diagnostic value for HSIL.3.To evaluate the diagnostic efficacy of the HPVE7 protein in HPV16-positive and TCT-negative patients,the negative predictive value was 69% and negative likelihood was 0.592.The critical value of HPVE7 protein concentration-≥ 2.765ng/ml was determined again using the ROC curve and Yoden index,we get the 92.3% of negative predictive value and the 0.1of negative likelihood ratio satisfactorily.So taking ≥2.765ng/ml as the critical value can help us screen out more non-diseased cases and reduce unnecessary colposcopy referrals.4.The patients who progressed in E7 protein-positive group were more than those in E7 protein-negative group,and the patients with HPV turned negative in E7protein-negative group were higher than E7 protein-positive group after flow-up of2 years(χ^2 = 14.899,P = 0.001).then We get a 82.4% of positive predictive value and 4.43 of positive likelihood ratio for LSIL and below,which suggests that the E7 protein detection has a very significant value in predicting the outcome of patients with LSIL and blow.There was no difference about the HPV status between E7 protein positive and negative groups in patients of HSIL after treatment(χ ^ 2 = 0.07,P = 0.79).5.Patients with HPV16-positive have a higher E7 protein conversion rate(82.6%)after treatment,especially after the invasive cervical treatment.Conclusions:1.The HPV16 E7 protein detection has good value in the diagnosis of HSIL,especially in patients with HPV(+)and TCT(-),which can reduce unnecessary colposcopy referral.2.HPV16 E7 protein detection has a good predictive value for LSIL and below.3.HPV16 E7 protein detection has significant value in the diagnosis and prediction of cervical precancerous lesions in clinical application.