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. 2023 Sep 29;18(1):54.
doi: 10.1186/s13027-023-00531-w.

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

Ying Liu  1   2 , Xiu Jin  2 , Yingying Gong  2 , Yingying Ma  2 , Beibei Du  2 , Linqing Yang  2 , Yunfei Wang  3 , Weipei Zhu  4
Affiliations

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

Ying Liu et al. Infect Agent Cancer. .

Erratum in

Abstract

Purpose: 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.

Methods: 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.

Results: 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 (χ2 = 653.214, P < 0.001). The percentages of LSIL + and HSIL + in the HPV16 + group (61.3% and 42.8%, respectively) and HPV16+/18/45 + group (76.3% and 41.9%, respectively) were much higher than those in the HPV18 + group (40.6% and 13.1%, respectively) (P < 0.001). However, there was no significant difference in the percentage of histopathological results between the HPV16 + group and HPV16+/18/45 + groups (P > 0.05). The above results were consistent after stratification according to age.

Conclusion: The rate of histopathological abnormalities was still high for the other HR-HPV subtypes with NILM cytology, although the rate of histopathological abnormalities was much higher for the HPV 16/18/45 positive subtypes. Therefore, colposcopy should be performed in women with HPV E6/E7 mRNA positivity and NILM cytology, regardless of age and HPV genotype.

Keywords: Cervical screening; Genotyping; HPV E6/E7 mRNA; NILM.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Management procedure, the results and outcomes. ASC-US, atypical squamous cells of undetermined significance; NILM, negative for intraepithelial lesions or malignancies; HPV, human papillomavirus; HPV16/18/45+, HPV16 + or HPV18/45+; HPV16+, HPV16 + and HPV18/45-; HPV18/45+, HPV16- and HPV18/45+; HPV16+/18/45+, HPV16 + and HPV 18/45+
Fig. 2
Fig. 2
The age distribution of 6845HPV E6/E7 mRNA-positive women
See this image and copyright information in PMC

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