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1.
J Zhejiang Univ Sci B ; 18(3): 249-255, 2017.
Article in English | MEDLINE | ID: mdl-28271660

ABSTRACT

Histological low-grade squamous intraepithelial lesion/cervical intraepithelial neoplasia grade 1 (LSIL/CIN1) preceded by normal or mildly abnormal cytology is recommended for conservative follow-up, with no separated management. In this study, we assessed the triage value of human papillomavirus (HPV) 16/18 genotyping in 273 patients with LSIL/CIN1. HPV16/18 genotyping was performed at baseline and follow-up was at 6-monthly intervals for up to 2 years. At each follow-up, women positive for cytology or high-risk HPV (hrHPV) were referred for colposcopy. Enrollment cytology, HPV16/18 genotyping, and questionnaire-obtained factors were linked to the 2-year cumulative progression rate. Univariate and multivariate analyses were performed taking into account time-to-event with Cox proportional hazard regression. The results showed that 190 cases (69.6%) regressed, 37 (13.6%) persisted, and 46 (16.8%) progressed. HPV16/18 positivity (hazard ratio (HR), 2.708; 95% confidence interval (CI), 1.432-5.121; P=0.002) is significantly associated with higher 2-year cumulative progression rate. Sub-analysis by enrollment cytology and age restricted the positive association among patients preceded by mildly abnormal cytology and aged 30 years or older. Immediate treatment is a rational recommendation for the high-risk subgroup, when good compliance is not assured.


Subject(s)
Colposcopy , Human papillomavirus 16/genetics , Human papillomavirus 18/genetics , Uterine Cervical Neoplasms/diagnosis , Adult , Disease Progression , Female , Follow-Up Studies , Genotype , Humans , Middle Aged , Prognosis , Proportional Hazards Models , Surveys and Questionnaires , Uterine Cervical Neoplasms/virology , Young Adult
2.
J Zhejiang Univ Sci B ; 18(3): 256-262, 2017.
Article in English | MEDLINE | ID: mdl-28271661

ABSTRACT

Cytology triage has been generally recommended for human papillomavirus (HPV)-positive women, but is highly dependent on well-trained cytologists. The present study was designed to explore whether HPV E6/E7 mRNA detection in cervical exfoliated cells can be a potential triage for HPV-positive women from a clinic-based population. Both the primary HPV testing and Papanicolaou (Pap) test were performed on all eligible HPV-positive women. HPV E6/E7 mRNA was detected by QuantiVirus® HPV E6/E7 mRNA assay in cervical exfoliated cells. All HPV-positive women underwent colposcopy and further biopsy if indicated. The data were assessed by Pearson's Chi-squared test and the receiver operating characteristic curve. A total of 404 eligible HPV-positive women were enrolled. Positive rate of E6/E7 mRNA in high-grade squamous intraepithelial lesion (HSIL) cases was higher than that in low-grade squamous intraepithelial lesion (LSIL) or normal cases. There was no statistical difference found between mRNA and cytological testing with sensitivity (89.52% vs. 86.67%, P=0.671), specificity (48.96% vs. 48.96%, P=1.000), positive predictive value (39.00% vs. 38.24%, P=1.000), and negative predictive value (92.76% vs. 90.97%, P=0.678) for detecting ≥HSIL. HPV E6/E7 mRNA detection in cervical exfoliated cells shows the same performance as Pap triage for HSIL identification for HPV-positive women. Detection of HPV E6/E7 mRNA may be used as a new triage option for HPV-positive women.


Subject(s)
Oncogene Proteins, Viral/genetics , Papillomaviridae , Papillomavirus E7 Proteins/genetics , RNA, Viral/genetics , Uterine Cervical Neoplasms/diagnosis , Adult , Aged , Biopsy , DNA, Viral/genetics , Female , Humans , Middle Aged , Models, Statistical , Predictive Value of Tests , RNA, Messenger/genetics , RNA, Messenger/metabolism , ROC Curve , Sample Size , Sensitivity and Specificity , Uterine Cervical Neoplasms/virology
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