Value analysis of HPV E6∕E7 mRNA detection in cervical cancer screening and diversion
Objective To compare the value of HPVE6∕E7 mRNA and HPV-DNA,respectively and in combination with TCT,in screening cervical lesions,and the value of E6∕E7 mRNA and HPV-DNA in ASC-US shunting.Methods 2079 women who underwent cervical cancer screening in our hospital from January 2022 to December 2023 were included in the study.TCT,HPV DNA,and HPV E6∕E7 mRNA tests were performed and those with negative results in all 3 categories were excluded.513 cases underwent vaginal biopsy.Using pathological reports as the gold standard,compare the positivity rates of HPV DNA and HPV E6∕E7 mRNA.Comparison of the efficacy of HPV DNA and HPV E6∕E7 mRNA screening alone and in combination with TCT screening for CIN2+(including CIN2,CIN3,and cervical cancer).Compare the efficiency of ASC-US for HPV DNA and HPV E6∕E7 mRNA diversion.Results The CIN1 rate in the HPV-DNA group was 4.08%,which higher than 2.45%in the E6∕E7 mRNA group(χ2=8.787,P=0.003).There was no statistically significant difference in the CIN2+detection rate between the two screening methods(χ2=0.250,P=0.617).The sensitivity and specificity of HPV-DNA and E6∕E7 mRNA in screening for CIN2+were 85.98%vs.81.09%and 49.57%vs.84.24%,respectively.The sensitivity of HPV-DNA screening was higher than that of E6∕E7 mRNA,while the specificity was lower than that of E6∕E7 mRNA.The differences in specificity,positive predictive value,and false positive rate between the two screening methods were statistically significant(χ2=94.732,32.802,94.732,P=0.000).The sensitivity and specificity of TCT combined with HPV-DNA and TCT combined with E6∕E7 mRNA for screening CIN2+were 94.51%vs.90.85%and 85.37%vs.90.26%,respectively.The combination of TCT improved the sensitivity and specificity of screening,but the specificity of TCT combined with HPV-DNA was still lower than that of TCT combined with E6∕E7 mRNA.The difference in specificity and false positive rate between the two combined screening methods was statistically significant(χ2=3.871,3.871,P=0.049).The area under the ROC curve of E6∕E7 mRNA in screening for CIN2+in ASC-US is 0.814,which is greater than that of HPV-DNA by 0.704,and the difference is statistically significant(χ2=2.352,P<0.05).Conclusion Compared with HPV-DNA,E6∕E7 mRNA alone and in combination with TCT screening for CIN2+have higher specificity,and have more advantages in shunt management of ASC-US.
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