Usefulness of E7 mRNA in HPV16-positive women to predict the risk of
progression to HSIL/CIN2+
Abstract
Objective: To evaluate whether E7 mRNA can predict the risk of
progression in women with HPV16 infection. Design: prospective
observational study Setting: Tertiary university hospital Population: A
cohort of 139 women referred to colposcopy for an abnormal screening
result fulfilling the following inclusion criteria: 1) a positive test
result confirming HPV16 infection; 2) a biopsy sample with a
histological diagnosis of absence of lesion or low-grade SIL/CIN grade1
(LSIL/CIN1); 3) no previous HPV vaccination; 4) no pregnancy; and 5) no
previous cervical treatments; and 6) no immunosuppression. Methods: At
the first visit all women underwent a cervical sample for liquid-based
cytology, HPV testing and genotyping, and HPV16 E7 mRNA analysis and a
colposcopy with at least one colposcopy-guided biopsy. Follow-up visits
were scheduled every six months. In each control a liquid-based Pap
smear, HPV testing, as well as a colposcopy examination with biopsy if
necessary were performed. Main outocome measures: Histological diagnosis
of HSIL/CIN2+ at any time during follow-up Results: E7 mRNA expression
was positive in 55/127 (43.3%) women included in the study and seven
(12.7%) progressed to HSIL/CIN2+. In contrast, only 1/72 (1.4%) women
with no HPV16 E7 mRNA expression progressed (p=0.027). HPV16 E7 mRNA
expression was associated with a 10-fold increased risk of progression
(HR 10.0; 95%CI 1.2-81.4). Conclusions: HPV16 E7 mRNA could be useful
for risk stratification of women with HPV16 infection in whom a
HSIL/CIN2+ has been ruled out.