Journal of Developmental Medicine(Electronic Version)  2022, Vol. 10 Issue (3): 203-208 DOI: 10.3969/j.issn.2095-5340.2022.03.007 |
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| Predictive value of HPV DNA detection, HPV E6/E7 mRNA detection and thinprep cytologic test for residual or recurrent lesions after cervical resection |
| Zhu Dahua, Chen Jialian, Hu Yang, et al
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Department of Gynecology,the Second People's Hospital of Yibin, Sichuan, Yibin 644000, China)
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Abstract 【Abstract】 Objective To analyze and compare the clinical application value of human papilloma
virus (HPV) DNA detection, HPV E6/E7 mRNA detection and thinprep cytologic test(TCT) in residual or
recurrence of postoperative cervical intraepithelial neoplasia (CIN3+). Method A total of 530 patients
with CIN3+ who underwent gynecological surgery in the Second People's Hospital of Yibin from April
2017 to August 2019 were selected as the research objects. The cases were followed up every 3 months aftersurgery for 4 times in total, and follow-up files were established. HPV DNA, HPV E6/E7 mRNA detection and TCT were used as follow-up monitoring indicators, and any abnormal indicators were referred to colposcopy for pathological diagnosis by biopsy and evaluated their follow-up value for postoperative residual or recurrence of lesions. Statistical methods were performed by t test or χ2 test. Result 530 CIN3+ patients who underwent cervical resection were followed up for 1 year, a total of 114 cases underwent colposcopy or biopsy, and a total of 18 cases were found to have residual lesions or recurrence, the ratio of residual lesions or recurrence was 5.7% (18/316). The negative rates of HPV E6/E7 mRNA at 3, 6, 9 and 12 months after surgery were 83.5% (264/316), 91.1% (288/316), 96.8% (306/316), 96.5% (305/316), respectively.The negative rates of TCT were 97.2% (307/316), 97.2% (307/316), 98.7% (312/316), 99.1% (313/316),respectively. The negative rates of HPV DNA were 53.2% (168/316), 72.8% (230/316), 81.0% (256/316),85.4% (270/316), respectively. The negative rates of HPV E6/E7 mRNA and HPV DNA showed a gradually increasing trend. The sensitivity [44.4% (8/18) vs 55.6% (10/18)] of HPV E6/E7 mRNA combined withTCT was lower than that of HPV DNA combined with TCT, but the specificity [94.8% (91/96)] and positivepredictive value [61.5% (8/13)] were higher than that of HPV DNA combined with TCT [89.6% (86/98) vs50.0% (10/20)] showed statistical significance (all P<0.05). Conclusion HPV E6/E7 mRNA combinedwith TCT detection has high specificity and positive predictive value for predicting CIN3+ or residual lesionsafter surgical treatment. It can be used to evaluate the prognosis of surgical treatment for high-grade cervical lesions, and detect patients with real risk of disease early. It can also help to avoid unnecessary excessive diagnosis and treatment, and reduce anxiety and stress of patients.
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Received: 23 September 2021
Published: 31 May 2022
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