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

Cervical cancer is a serious cancer that threatens women’s health. Cervical cancer incidence and mortality have increased yearly in China over the last 20 years, and the impact on young women has also increased [1,2,3]. The main cause of cervical cancer is persistent infection with high-risk human papillomavirus (HPV) [4, 5]. Cervical cancer prevention is universal around the world. However, cervical cancer vaccination began late in China and vaccination coverage is low [6, 7]. As a result, it is critical that we upgrade our current screening mechanism.

Traditional Pap screenings have performed poorly in underdeveloped countries, with a sensitivity ranging from 30 to 40% [8]. Despite the improved performance of liquid-based cytology, the number of cytopathologists in the country remains inadequate, and diagnostic skills vary, limiting the use of this technology in routine screening. Zhao et al. [9] reported that liquid-based cytology had lower sensitivity for detecting CIN2+ (80.7%). Given the oncogenic cause, HPV testing can be a valid technique for diagnosing the risk of cervical cancer in women. Women who have normal sexual intercourse have a lifetime possibility of being infected with at least one type of HPV of up to 80% [10], but most HPV infections are transient; because HPV DNA testing cannot identify transient HPV infections, it leads to unnecessary follow-up and even overtreatment of HPV-infected patients, increasing the financial and psychological burden of patients [11].

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

Xem thêm : Label: BUPROPION HYDROCHLORIDE tablet, extended release

The E6/E7 oncogenes are well known to play an important role in the development of cervical cancer. Because E6/E7 overexpression occurs after HPV integration into the genome, direct detection of HR-HPV E6/E7 in cervical samples may be more specific in detecting high-grade cervical lesions than HR-HPV-DNA testing [12]. Compared with HPV DNA testing using a noninferiority scoring method, HPV E6/E7 mRNA testing passed the cross-sectional clinical and reproducibility requirements of international CIN2 + detection HPV testing [13, 14]. As a result, the number of patients who use E6/E7 mRNA for HPV testing is increasing yearly in China [15,16,17]; however, there is a lack of uniform clinical standards and guidelines for the management of HPV E6/E7 mRNA-positive patients, and an increasing number of patients who are positive for genotypes other than 16 and 18/45 are being referred for colposcopy and cervical biopsy. As a result, a major study evaluating triage techniques for different genotypes of HPV E6/E7 mRNA positivity in women with normal liquid-based cytology is needed.

In this study, we analysed the pathological diagnosis of cervical biopsy in patients positive for different genotypes of HPV E6/E7 mRNA in the presence of normal liquid-based cytology. We preliminarily discussed the need for referral colposcopy and cervical biopsy in patients positive for different genotypes of HPV E6/E7 mRNA to provide feasible suggestions and a basis for clinicians for follow-up management.

Nguồn: https://buycookiesonline.eu
Danh mục: Blog