Evaluation of HPV E6/E7 mRNA in predicting recurrence after Leep in cervical intraepithelial neoplasia: A study of negative findings.

Abstract

Cervical intraepithelial neoplasia (CIN) is a precursor to cervical cancer, and early detection of residual or recurrent disease is therefore critical for effective management. This study evaluated whether HPV E6/E7 mRNA status predicts recurrence in patients with CIN who underwent loop electrosurgical excision procedure (LEEP). People's Hospital of Nanning between January 2019 and July 2022 were included. Patients who underwent LEEP for high-grade cervical lesions at the First Follow-up commenced 4-6 months after LEEP and continued for 24 months; abnormal findings during this period prompted referral for colposcopy or cervical biopsy. Of the 91 patients, 3 (3.30%) experienced recurrence within 24 months. Recurrence rates were similar between patients with preoperative E6/E7 mRNA positivity (3.23%) and negativity (3.45%) (p = 0.956), and between postoperative E6/E7 mRNA status groups (5.26% in the negative group vs. 0% in the positive group; p = 0.814). Although 66.7% of patients shifted from positive to negative E6/E7 mRNA status after LEEP (p < 0.001), this change was not associated with recurrence risk. Preoperative E6/E7 mRNA yielded a sensitivity of 66.67% and specificity of 31.82%, whereas postoperative E6/E7 mRNA showed a sensitivity of 0% and specificity of 97.30%. In conclusion, E6/E7 mRNA status before and after LEEP did not predict recurrence in patients with CIN. Despite a significant reduction in E6/E7 mRNA positivity after surgery, its low sensitivity underscores the need for more effective biomarkers in follow-up care.