Study On The Association Between Cervical Epithelial E6/E7mRNA Expression And Cervical Lesions

Objective:To explore the relationship between the HPV E6/E7 m RNA expression and cervical lesions in high-risk human papilloma virus(HR-HPV) infected people.To explore the value of screening and risk assessment effectiveness for cervical cancer and precancerous lesions by branched DNA(b-DNA) technology detecting HPV E6/E7 m RNA in HR-HPV infected cervical exfoliated cells. Methods:1. The cervical exfoliated cells were collected from 265 samples of HR-HPV infection, including 100 samples of normal/inflammation(control group), 88 samples of cervical intraepithelial neoplasia(CIN)Ⅰ, 33 samples of CINⅡ, 28 samples of CIN and 16Ⅲ samples of cervical carcinoma patients who were diagnosed by Second Affiliated Hospital to Tianjin Medical University Department of gynaecology colposcope directed biopsy histopathological examination.2. b-DNA technology to detect HPV E6/E7 m RNA expression of HR-HPV infected cervical exfoliated cells.3. Evaluate the value of HPV E6/E7 m RNA detection in auxiliary diagnosis of cervical cancer and precancerous lesions, forecast the risk of suffering from cervical cancer in HR-HPV infection, to provide more accurate, reliable, and more predictable indicators for CIN and cervical cancer screening. Results:1. With the increase of pathological level, HPV E6/E7 m RNA present a tendency of increasing positive rate and expression(P < 0.05); Comparing with normal inflammation group and CIN Ⅰgroup, the positive rate and expression of HPV E6/E7 m RNA in the lesion ≧CIN Ⅱ(including CIN Ⅱ, CIN Ⅲ, cervical cancer) were significantly higher and had significant differences(P < 0.005);2. With the increase of TCT diagnosis level, HPV E6/E7 m RNA present a tendency of increasing positive rate and expression(P < 0.05); Comparing with non squamous intraepithelial lesion(NSIL), atypical squamous cells(ASC) and low-grade squamous intraepithelial lesion(LSIL) group, the positive rate and expression quantity of HPV E6/E7 m RNA in high-grade squamous intraepithelial lesion(HSIL) and cancer group were significantly higher and had significant difference(P < 0.005).3. Seventeen subtypes of HR-HPV were detected including:HPV16,18, 58,56,52,51,68,33,53,39,59,31,35,45,67,66 and 73. CINⅢ and cervical cancer group of HPV16 positive rate higher than normal, CIN Ⅰ, CIN Ⅱgroup. Other subtypes were no difference between groups.Compared simple type infection and multiple type infection group of HR-HPV infected, there was no significant difference of HPV E6/E7 m RNA expression quantity(P > 0.05).4. The diagnostic sensitivity,speciality,ppv,npv,Youden’s index and crude agreement of HPV E6/E7 m RNA detection in lesions CIN ≧ Ⅱof HR-HPV infected, were higher than the TCT detection(88.31% vs.77.92%,88.31%vs.77.92%,57.14% vs. 48.78%,93.84% vs. 88.03%,0.61 vs. 0.44,77.34% vs. 69.81%). Conclusions:1. HPV E6/E7 m RNA detection can reflect the activity of the virus and the progression of lesions, especially for screening out the high level of cervical lesion( CIN ≧ Ⅱ), can be more effective to find out the real people at high risk, reduce the excessive treatment, provides a good basis for predicting risk, may be as a molecular indicator of screening for cervical cancer and precancerous lesions.2. The progress of the cervical lesions associated with HPV genotypes in pathogenicity, but has nothing to do with the amount of genotype. Whether or not multiple infected, people who have HPV16 infection or high E6 / E7 m RNA expression, shall be regarded as crowd at high risk of cervical cancer.3. b-DNA technology detecting HPV E6/E7 m RNA supplements the deficiency of the traditional method for cervical cancer screening, may provides a new basis for shunting the crowed of cervical cytology ASC-US, also is expected to become the index of patients with postoperative cervical disease review.