Do women with high-risk HPV E6/E7 mRNA test positivity and NILM cytology need colposcopy?

Infectious Agents and Cancer

Research

Yingying Gong¹  Beibei Du¹  Ying Liu¹  Weipei Zhu¹  Yingying Ma¹  Xiu Jin¹  Linqing Yang¹  Yunfei Wang¹ 

[1] Department of Obstetrics and Gynecology, The Second Affiliated Hospital of Soochow University, 215000, Suzhou, China;Department of Gynecology, Affiliated Hospital of Jining Medical University, 272000, Shandong, China;

关键词: Cervical screening;    HPV E6/E7 mRNA;    NILM;    Genotyping;   

DOI  :  10.1186/s13027-023-00531-w

 received in 2023-03-08, accepted in 2023-09-11,  发布年份 2023

来源: Springer

【 摘 要 】

PurposeThis study aimed to assess the value of an HPV E6/E7 mRNA assay and HPV 16 18/45 genotype assay combined with age stratification for triaging women negative for intraepithelial lesions or malignancy (NILM) cytology.MethodsFrom January 2017 to December 2021, a total of 162,309 eligible women underwent cervical cancer screening at the Affiliated Hospital of Jining Medical University, China. Excluding those with negative HPV E6/E7 mRNA, abnormal and unsatisfactory cytology, and those who failed to undergo colposcopy, 6,845 women were ultimately included in our study. We analysed the triage guidance for different subtypes of HPV in the presence of NILM cytology.ResultsAmong 162,309 women, 19,834 (12.2%) were positive for HPV E6/E7 mRNA. Of the 6,845 women included in the study, 1,941 (28.4%), 561 (8.2%), 55 (0.8%) and 4,288 (62.6%) tested positive for HPV 16, HPV 18/45, HPV16/18/45 or other HR-HPV genotypes, respectively. The proportions of LSIL+ (including LSIL, HSIL and ICC) and HSIL+ (including HSIL and ICC) pathological results in the HPV 16/18/45 + group were 57% and 34.1%, respectively, higher than 36.3% and 11% in the other HR-HPV + group (χ2 = 653.214, P < 0.001). The percentages of LSIL + and HSIL + in the HPV16 + group (61.3% and 42.8%, respectively) and HPV16+/18/45 + group (76.3% and 41.9%, respectively) were much higher than those in the HPV18 + group (40.6% and 13.1%, respectively) (P < 0.001). However, there was no significant difference in the percentage of histopathological results between the HPV16 + group and HPV16+/18/45 + groups (P > 0.05). The above results were consistent after stratification according to age.ConclusionThe rate of histopathological abnormalities was still high for the other HR-HPV subtypes with NILM cytology, although the rate of histopathological abnormalities was much higher for the HPV 16/18/45 positive subtypes. Therefore, colposcopy should be performed in women with HPV E6/E7 mRNA positivity and NILM cytology, regardless of age and HPV genotype.

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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