Do women with high-risk HPV E6/E7 mRNA test positivity and NILM cytology need colposcopy?

• Published in: Infectious agents and cancer 2023-09, Vol.18 (1), p.54-8, Article 54
• Main Authors: Liu, Ying, Jin, Xiu, Gong, Yingying, Ma, Yingying, Du, Beibei, Yang, Linqing, Wang, Yunfei, Zhu, Weipei
• Format: Article
• Language: English
• Subjects: Age; Biopsy; Cancer; Cancer screening; Cellular biology; Cervical cancer; Cervical screening; Cervix; Colposcopy; Cytology; Diagnosis; Genetic testing; Genotypes; Genotyping; Health aspects; HPV E6/E7 mRNA; Human papillomavirus; Immunization; Malignancy; Medical colleges; Medical screening; Messenger RNA; mRNA; NILM; Papillomavirus infections; Women; Womens health
• ISSN: 1750-9378; 1750-9378
• DOI: 10.1186/s13027-023-00531-w

This study aimed to assess the value of an HPV E6/E7 mRNA assay and HPV 16 18/45 genotype assay combined with age stratification for triaging women negative for intraepithelial lesions or malignancy (NILM) cytology. From January 2017 to December 2021, a total of 162,309 eligible women underwent cervical cancer screening at the Affiliated Hospital of Jining Medical University, China. Excluding those with negative HPV E6/E7 mRNA, abnormal and unsatisfactory cytology, and those who failed to undergo colposcopy, 6,845 women were ultimately included in our study. We analysed the triage guidance for different subtypes of HPV in the presence of NILM cytology. Among 162,309 women, 19,834 (12.2%) were positive for HPV E6/E7 mRNA. Of the 6,845 women included in the study, 1,941 (28.4%), 561 (8.2%), 55 (0.8%) and 4,288 (62.6%) tested positive for HPV 16, HPV 18/45, HPV16/18/45 or other HR-HPV genotypes, respectively. The proportions of LSIL+ (including LSIL, HSIL and ICC) and HSIL+ (including HSIL and ICC) pathological results in the HPV 16/18/45 + group were 57% and 34.1%, respectively, higher than 36.3% and 11% in the other HR-HPV + group (χ  = 653.214, P