Efficacy of HPV E6/E7 mRNA assay, HPV DNA test and cytology in detection of high grade cervical lesions and invasive cancer at a tertiary care center in India

IF 1.2 4区医学 Q4 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Malawi Medical Journal Pub Date : 2024-07-14 DOI:10.4314/mmj.v36i2.9

Sangeeta Pankaj, Jyotsna Rani, Pratibha Kumari, Kavya Abhilashi, V. Choudhary, S. Kumari, S. Shahi, Anima Xess, Rajesh Kumar Singh, Shishir Kumar, Abhay Kumar, Nihar Ranjan Biswas, Babban Jee

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引用次数: 0

Abstract

BackgroundCervical cancer is caused by human papillomavirus (HPV) and remains a major public health issue. There are several methods for its diagnosis. Knowing their comparative usefulness may help in devising an appropriate strategy for early detection of this gynecological cancer in resource-constrained setting. AimThis study aims to evaluate the efficacy of human papillomavirus (HPV) E6/E7 mRNA assay, HPV DNA test and cytology in detection of high grade cervical lesions and invasive cervical carcinoma at a tertiary care center in India.MethodsA total of 106 women were recruited in this hospital based study and underwent molecular tests (HPV DNA test and mRNA assay), cytological test and colposcopic-guided biopsy. Histopathological diagnosis was considered as the gold standard. ResultsWe observed that 56 out of 106 participants had abnormal results in the terms of positive HPV DNA or E6/E7 mRNA with or without abnormal cytology or had histopathologically confirmed pre-malignant/malignant lesion. 47.2% (50/106) and 32% (34/106) women were positive for HPV DNA and E6/E7 mRNA respectively. 33% (35/106) women had abnormal cytology and 29.2% (31/106) had histologically confirmed CIN II and higher lesions. Sensitivity and specificity of cytology and HPV DNA for CIN III+ lesions were calculated as 92%, 90.4% versus 88% & 68% respectively. mRNA assay was found to be more sensitive (96%) and specific (93.3%) than other tests in detecting CIN II + lesions. ConclusionE6/E7 mRNA assay seems superior to HPV DNA test and cytology in detection of high grade cervical lesions and invasive carcinoma. It may be used as an alternative or adjunct to HPV DNA test or cytology for the purpose of cervical cancer screening and also be helpful in reducing the load for colposcopy.

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在印度的一家三级医疗中心，HPV E6/E7 mRNA 检测、HPV DNA 检测和细胞学检测在发现高级别宫颈病变和浸润性癌症方面的功效

背景宫颈癌是由人类乳头瘤病毒（HPV）引起的，目前仍是一个重大的公共卫生问题。目前有多种诊断方法。了解这些方法的比较作用有助于在资源有限的情况下制定早期检测这种妇科癌症的适当策略。本研究旨在评估人乳头状瘤病毒（HPV）E6/E7 mRNA 检测、HPV DNA 检测和细胞学检测在印度一家三级医疗中心检测高级别宫颈病变和浸润性宫颈癌方面的效果。方法在这项基于医院的研究中，共招募了 106 名妇女，她们接受了分子检测（HPV DNA 检测和 mRNA 检测）、细胞学检测和阴道镜引导下活检。组织病理学诊断被视为金标准。结果我们发现，106 名参与者中有 56 人出现异常结果，即 HPV DNA 或 E6/E7 mRNA 阳性，伴有或不伴有异常细胞学检查，或经组织病理学证实为恶性前病变/恶性病变。分别有 47.2% （50/106）和 32% （34/106）的妇女的 HPV DNA 和 E6/E7 mRNA 呈阳性。33%（35/106）的妇女细胞学检查结果异常，29.2%（31/106）的妇女经组织学确诊为 CIN II 及以上病变。经计算，细胞学和 HPV DNA 检测 CIN III+ 病变的敏感性和特异性分别为 92%、90.4% 与 88% 和 68%。在检测 CIN II+ 病变方面，mRNA 检测的敏感性（96%）和特异性（93.3%）高于其他检测方法。结论在检测高级别宫颈病变和浸润癌方面，E6/E7 mRNA 检测似乎优于 HPV DNA 检测和细胞学检测。在宫颈癌筛查中，它可作为 HPV DNA 检测或细胞学检测的替代或辅助手段，也有助于减少阴道镜检查的工作量。

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来源期刊

Malawi Medical Journal Medicine-General Medicine

CiteScore

1.50

自引率

0.00%

发文量

审稿时长

>12 weeks

期刊介绍： Driven and guided by the priorities articulated in the Malawi National Health Research Agenda, the Malawi Medical Journal publishes original research, short reports, case reports, viewpoints, insightful editorials and commentaries that are of high quality, informative and applicable to the Malawian and sub-Saharan Africa regions. Our particular interest is to publish evidence-based research that impacts and informs national health policies and medical practice in Malawi and the broader region. Topics covered in the journal include, but are not limited to: - Communicable diseases (HIV and AIDS, Malaria, TB, etc.) - Non-communicable diseases (Cardiovascular diseases, cancer, diabetes, etc.) - Sexual and Reproductive Health (Adolescent health, education, pregnancy and abortion, STDs and HIV and AIDS, etc.) - Mental health - Environmental health - Nutrition - Health systems and health policy (Leadership, ethics, and governance) - Community systems strengthening research - Injury, trauma, and surgical disorders