Triage Value of Cervical Exfoliated Cell DNA Ploidy Analysis in Cervical High-Risk Human Papillomavirus-Positive Women.

OBJECTIVE: This study aimed to investigate the triage value obtained in DNA ploidy analysis of cervical exfoliated cells in women with high-risk human papillomavirus (HR-HPV)-positive status in the primary screening of cervical cancer. METHODS: The authors selected 3,000 HR-HPV-positive women for cervical exfoliated cell sampling and conducted DNA ploidy analysis, liquid-based cytology (LBC), colposcopy, and cervical biopsy. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of high-grade squamous intraepithelial lesion (HSIL)-positive detection between DNA ploidy analysis and LBC were compared according to histopathology diagnosis as the golden criteria, and the efficacy of predicting HSIL-positive immediate risk was evaluated. RESULTS: A total of 2,892 HR-HPV-positive women were enrolled in the investigation. For HSIL+ women, the DNA ploidy group showed a significantly higher sensitivity (CIN2+: 79.21% vs 65.35%, p = .022; CIN3+: 81.48% vs 70.37%, p = .013), lower specificity (CIN2+: 85.00% vs 96.59%, p < .001; CIN3+: 84.14% vs 93.41%, p < .001), and lower PPV (CIN2+: 16.23% vs 29.33%, p = .001; CIN3+: 8.92% vs 16.89%, p = .002) compared with the LBC group, whereas the NPV showed no significant difference. Compared with LBC alone in diagnosing HSIL, DNA ploidy combined with LBC showed higher specificity (CIN2+: 99.21% vs 96.59%, p = .003; CIN3+: 96.48% vs 93.41%, p < .001) and higher PPV (CIN2+: 41.35% vs 29.33%, p = .022; CIN3+: 24.81% vs 16.89%, p = .028), whereas no significant difference was observed in the sensitivity (CIN2+: 54.46% vs 65.35%, p = .063; CIN3+: 61.11% vs 70.37%, p = .221) and NPV ( p > .05). Among the HR-HPV-positive women positive for DNA ploidy, the imminent risk of CIN2+ and CIN3+ were 15.62% and 8.92%, respectively, above the threshold for the colposcopy positive rate. Among the positive cases both for DNA ploidy and the LBC result of negative for intraepithelial lesion or malignancy, the immediate risk of CIN3+ was 3.31%, below the threshold for colposcopy positive rate. Besides, for women with LBC result of ASC-US and above, the immediate risk of CIN3+ was greater than 4%. CONCLUSIONS: The DNA ploidy analysis can be used as an effective triage method for HR-HPV-positive women during the primary screening of cervical cancer, although it can provide higher specificity when combined with LBC and reduce the referral rate for colposcopy.

Characteristics and Related Factors of High-Risk Human Papillomavirus Infection in Pregnant Women.

BACKGROUND Cervical cancer is a risk for women worldwide. The aim of this study was to examine the occurrence of high-risk human papillomavirus (HR-HPV) infection and its related factors in pregnant women and provide a scientific basis for the targeted prevention and treatment of cervical cancer in pregnant women. MATERIAL AND METHODS A total of 1774 pregnant women were included, and 1774 non-pregnant women were selected as controls. Cervical exfoliated cells were collected from all women for HR-HPV (AptimaE6, E7mRNA) and ThinPrep cytologic testing, and the vaginal discharge of all pregnant women was tested for pH level and routine pathogenic microorganisms. RESULTS The HPV-16-positive and HPV-16/18/45-positive rates in pregnant women were higher than those of non-pregnant women (P<0.05). There was a statistically significant difference in HR-HPV-positive rate, HPV-16-positive rate, and non-HPV-16/18/45-positive rate among pregnant women of different ages (P<0.05). There was a statistically significant difference in HR-HPV-positive rate and non-HPV-16/18/45-positive rate in the first, second, and third trimester (P<0.05). The HR-HPV-positive rate, HPV-16-positive rate, HPV-18/45-positive rate, and non-HPV-16/18/45-positive rate of pregnant women with concurrent infection were higher than those in women without concurrent infection (P<0.05). The HR-HPV-positive and HPV-16/18/45-positive rates in pregnant women were associated with cytologic examination results (P<0.05). CONCLUSIONS The overall infection rates of HR-HPV-16 and HR-HPV-18/45 in pregnant women were higher than those in non-pregnant women. The gestation period was found to be a susceptible period for infection with HR-HPV, and we recommend the implementation of cervical cancer screening based on HR-HPV testing in pregnant women.

miR-587 promotes cervical cancer by repressing interferon regulatory factor 6.

BACKGROUND: Interferon regulatory factor 6 (IRF6) exhibits tumor-suppressive functions in several cancer types. In the present study, the antitumor properties and related pathway mechanism of IRF6 were investigated in cervical cancer. METHODS: Forty-one pairs of cervical cancer specimens and para-carcinoma tissues were collected to evaluate IRF6 expression using immunohistochemical staining and miR-587. The effects of miR-587 and IRF6 on cervical cancer cell growth were explored by MTT assays and in a HeLa tumor xenograft mouse model. The migration and invasion of cervical cancer cells were monitored using transwell assays. RESULTS: IRF6 expression in cervical cancer specimens and cell lines was significantly reduced compared to that in the corresponding control group. In addition, IRF6 expression was negatively correlated with miR-587 in cervical cancer tissues. Bioinformatics algorithms and luciferase assays revealed that IRF6 is a potential target of miR-587, and miR-587 mimic transfection led to a significant repression of IRF6 protein levels in cervical cancer cells. We also discovered that the antineoplastic properties of IRF6 could be reversed by overexpressing miR-587 in cervical cancer cells. The up-regulation of miR-587 was correlated with poor overall survival in cervical cancer. In an in vivo experiment, miR-587 silencing induced HeLa tumor growth inhibition, which was associated with the up-regulation of IRF6 protein in the tumor. CONCLUSIONS: miR-587 post-transcriptionally represses IRF6 protein expression to abrogate the antineoplastic activity of IRF6. The miR-587/IRF6 signaling pathway plays a crucial role in the progression of cervical cancer and serves as a potential therapeutic target for the treatment of cervical cancer.