Assessment of HPV-mRNA test to predict recurrent disease in patients previously treated for CIN 2/3

Frega, A; Sesti, Francesco; Lombardi, Danila; Votano, Sergio; Sopracordevole, Francesco; Catalano, Angelica; Milazzo, G.; Lombardo, Riccardo; Assorgi, Chiara; Olivola, Sara; Chiusuri, Valentina; Ricciardi, Enzo; French, Deborah; Mangino, Massimo

doi:10.1016/j.jcv.2014.01.017

Cited by 13 publications

(13 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…HPV E6/E7 mRNA was more sensitive and less specific for predicting the outcome of CIN2 but performed worse than routine histopathological assessments. This result is similar to the study by Frega et al (28), where HPV E6/E7 mRNA was indicated to have a high sensitivity and negative predictive value, which may be used to predict the recurrence of cervical lesions.…”

Section: Prognosis Of Cin2 ------------------------------------------supporting

confidence: 91%

Analysis of factors affecting the prognosis of patients with cervical intraepithelial neoplasia 2

Zhang

Meng

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

According to the 2014 World Health Organization Classification of Tumors of Female Reproductive Organs, patients with cervical intraepithelial neoplasia 2 (CIN2) have an equivocal diagnosis, but p16 is considered as the reference index for CIN2. Positive p16 expression in CIN2 is associated with high-grade squamous intraepithelial lesions (HSIL), whereas p16 negative lesions are low-grade squamous intraepithelial lesions. The purpose of the present study was to examine the clinical value of p16 and human papillomavirus (HPV) E6/E7 mRNA in the prognostication of patients with CIN2. From January 2013 to January 2016, 108 patients were diagnosed with CIN2 by biopsy and followed up at 6-month intervals at Peking University People's Hospital (Beijing, China). The expression of HPV E6/E7 mRNA was detected by in situ hybridization, while the expression of p16 and Ki-67 proteins was detected by immunohistochemistry. Of the 108 CIN2 cases, 20 progressed to HSIL/CIN3, 36 cases demonstrated persistence with CIN2 after the follow-up and 52 cases achieved regression (≤CIN1). Of the p16-positive 82 cases, 20 cases were detected to have progressed, whereas in the p16-negative group, no progression was observed. There were statistically significant differences among the p16-positive and negative groups (P<0.05). In the HPV E6/E7 mRNA-positive 69 cases, 18 cases were detected to have progressed, whereas in the HPV E6/E7 mRNA-negative 39 cases, progression was detected in only 2 cases. There were statistically significant differences among the HPV E6/E7 mRNA-positive and negative groups (P<0.05). The area under the receiver operating characteristics curve was plotted; the area under the curve for HPV E6/E7 mRNA was 0.745, that for p16 was 0.546 and that for Ki-67 was 0.501. The detection of HPV E6/E7 mRNA may provide important predictive information for the prognosis of CIN2, however p16 and Ki-67 proteins may provide little value.

show abstract

Section: Prognosis Of Cin2 ------------------------------------------supporting

confidence: 91%

Analysis of factors affecting the prognosis of patients with cervical intraepithelial neoplasia 2

Zhang

Meng

et al. 2020

Oncol Lett

View full text Add to dashboard Cite

show abstract

“…This is the reason why hrHPV-DNA testing owns a lower specificity than cytology in identifying relapse or persistent disease. Recent prospective studies have documented that rates of residual or recurrent disease in women with persistent hrHPV 16 and/or 18 are higher than in women with other hrHPV types, stressing the importance of type–specific genotyping determination after treatment for CIN2+ [ 38 – 40 ]. As hrHPV-genotyping assays have become increasingly utilised in clinical practice, further research will be needed to determine whether type-specific HPV results can improve the identification of women most likely at higher risk of developing cervical disease after treatment.…”

Section: Hpv Mrna Testing In the Follow-up After Conservative Treatmementioning

confidence: 99%

“…A recent systematic review highlights that new HPV infections are a potential source for future disease risk after treatment for cervical pre-cancer and cancer [ 41 ]. More recently, it has been suggested that the oncogene activity by hr-mRNA transcripts [ 42 ] may be a better indicator of women at risk of persistence or relapse of the disease, showing an higher specificity than DNA-based assays, having a better specificity and negative predicting value (NPV) than hrHPV-DNA testing [ 43 ], while others underline that HPV E6/E7 mRNA is not useful to detect relapse [ 2 ]. In order to assess the performance of different biomolecular tests, alone or in cotesting with cytology, an Italian prospective study is on-going to evaluate the prediction of persistence/recurrence rate in women treated for CIN2+.…”

Section: Hpv Mrna Testing In the Follow-up After Conservative Treatmementioning

confidence: 99%

E6/E7 mRNA testing for human papilloma virus-induced high-grade cervical intraepithelial disease (CIN2/CIN3): a promising perspective

Origoni

Cristoforoni

Carminati

et al. 2015

ecancer

View full text Add to dashboard Cite

Since the introduction of biomolecular testing for the identification of high-risk human papillomavirus DNA (hrHPV-DNA) in cervical cancer preventive strategies, many interesting aspects have emerged in this field; firstly, HPV-DNA testing has been demonstrated to have better sensitivity than conventional cytology in several settings: screening, triage of ASC-US and in follow-up after treatment. Despite this, some limitations of these new technologies have also been underlined: the major issue is the low specificity of the tests, which cannot discriminate between regressive and progressive infections. Thus, recent research has moved the attention towards novel markers of progression that could more precisely detect cases at real risk of cancer development. In view of the fact that progression to cancer is dependable of the E6/E7 proteins integration and transforming action, the overexpression of E6/E7 transcripts has been seen as a valuable marker of this risk. This review aims to summarise the literature data on this topic and to provide a clear view of the emerging perspectives.

show abstract

“…Moreover recent studies suggest that the oncogenic activity of hrHPV-mRNA transcripts [ 16 ] may be a better indicator of women at risk for persistent disease or relapse showing a higher specificity and NPV than DNA based assay [ 17 ], while other reports point out that HPV E6/E7 mRNA is not useful for detecting relapse [ 18 ]; therefore more consistent data are necessary in order to delineate the usefulness of hrHPV-mRNA in clinical practice.…”

Section: Hpv Genotyping and Risk Stratificationmentioning

confidence: 99%

Performance of HPV DNA testing in the follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ (AIS) and microinvasive carcinoma

Costa

Venturoli

Origoni

et al. 2015

ecancer

View full text Add to dashboard Cite

BackgroundOver the last two decades it has become clear that distinct types of human papillomavirus (HPV), the so-called high-risk types (hrHPV), are the major cause of cervical cancer. The hrHPV-DNA testing has shown excellent performance in several clinical applications from screening to the follow-up of conservatively treated patients.MethodsWe conducted a systematic review of the recent literature on the performance of HPV DNA testing in follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ, and microinvasive carcinoma compared to Pap smear cytology.ResultsObservational studies have demonstrated that the high risk hrHPV-DNA test is significantly more sensitive (95%) compared to follow-up cytology(70%) in detecting post-treatment squamous intraepithelial high-grade lesions. Moreover, in patients treated conservatively for cervical adenocarcinoma in situ, the hrHPV-DNA test is the most significant independent predictor of recurrent disease or progression to invasive cancer, and the combination of viral DNA testing and cytology reaches 90% sensitivity in detecting persistent lesions at the first follow-up visit and 100% at the second follow-up visit. The cause of microinvasive squamous cervical carcinoma is increasingly treated with conservative therapies in order to preserve fertility, and an effective strategy allowing early detection of residual or progressive disease has become more and more important in post-treatment follow-up. Primary results seem to indicate that the median time for viral clearance is relatively longer compared with patients treated for CIN and suggest a prolonged surveillance for these patients. However, the potential clinical value of HPV-DNA testing in this clinical setting needs to be confirmed by further observations.ConclusionsThe excellent sensitivity, negative predictive value, and optimal reproducibility of the hrHPV DNA testing, currently is considered a powerful tool in the clinicians’ hands to better manage post-treatment follow-up either in cervical squamous lesion or in situ adenocarcinoma.

show abstract

Assessment of HPV-mRNA test to predict recurrent disease in patients previously treated for CIN 2/3

Cited by 13 publications

References 23 publications

Analysis of factors affecting the prognosis of patients with cervical intraepithelial neoplasia 2

Analysis of factors affecting the prognosis of patients with cervical intraepithelial neoplasia 2

E6/E7 mRNA testing for human papilloma virus-induced high-grade cervical intraepithelial disease (CIN2/CIN3): a promising perspective

Performance of HPV DNA testing in the follow-up after treatment of high-grade cervical lesions, adenocarcinoma in situ (AIS) and microinvasive carcinoma

Contact Info

Product

Resources

About