title: High-risk human papillomavirus E6/E7 mRNA and L1 DNA as markers of residual/recurrent             cervical intraepithelial neoplasia.
abstract: The aim of this study was to assess the use of human papillomavirus (HPV)             E6/E7 mRNA testing in the follow-up of women treated for cervical intraepithelial             neoplasia (CIN) by conization and to compare the prognostic value of HPV E6/E7             mRNA to HPV L1 DNA and cytology. One hundred and forty-three women underwent cytological/histological             testing, HPV DNA genotyping by Linear Array, and HPV E6/E7 mRNA testing by APTIMA             HPV assay during follow-up after surgical treatment for histologically verified             CIN. High-grade residual/recurrent disease (CIN2+/HSIL+) was identified in 7 (4.9%)             women, and low-grade disease (CIN1/LSIL) in 25 (17.5%). At the inclusion visit             33 (23%) women were HPV DNA-positive; 13 (9.0%) were HPV E6/E7 mRNA-positive.             HPV E6/E7 mRNA did not identify three women with high-grade disease. Presence             of high-risk HPV DNA at the inclusion visit predicted 100% (95% CI 64.6-100) of             high-grade residual/recurrent disease, with a specificity of 80.9% (95% CI 73.5-86.6);             cytology had a sensitivity of 85.7%, and a specificity of 87.5%. HPV E6/E7 mRNA             testing was a poor predictor of treatment failure, with a sensitivity of 57.1%             (95% CI 25.0-84.2), but high specificity (93.4%; 95% CI 87.9-96.5). Detection             of high-risk HPV DNA after treatment by conization identified 100% of women with             residual/recurrent high-grade disease, whereas HPV E6/E7 mRNA testing was a poor             predictor of treatment failure. This study suggests that a negative HPV mRNA result             cannot exclude the risk of malignant progression, and that HPV E6/E7 mRNA testing             by APTIMA HPV assay is not useful in the follow-up of women treated for CIN.
authors.affiliation: Department of Women's and Children's Health, Division of Obstetrics and Gynecology, Karolinska Institutet, Elevhemmet H2:00, Karolinska University Hospital Solna, 171 76 Stockholm, Sweden.
authors.forename: Maria
authors.initials: M
authors.lastname: Persson
authors.forename: Sophia
authors.initials: S
authors.lastname: Brismar Wendel
authors.forename: Linda
authors.initials: L
authors.lastname: Ljungblad
authors.forename: Bo
authors.initials: B
authors.lastname: Johansson
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Sonia
authors.initials: S
authors.lastname: Andersson
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000235:genetics*; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism*; D036022:Capsid Proteins / Q000235:genetics* / Q000378:metabolism; D002584:Cervix Uteri / Q000473:pathology / Q000821:virology; D019092:Conization; D005260:Female; D005500:Follow-Up Studies; D015870:Gene Expression; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000378:metabolism / Q000821:virology*; D018365:Neoplasm, Residual; D009856:Oncogene Proteins, Viral / Q000235:genetics* / Q000378:metabolism; D050725:Papillomavirus E7 Proteins / Q000235:genetics* / Q000378:metabolism; D030361:Papillomavirus Infections / Q000821:virology*; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012367:RNA, Viral / Q000235:genetics / Q000378:metabolism; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000378:metabolism / Q000821:virology*; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000378:metabolism / Q000821:virology*
chemical_list: D014408:Biomarkers, Tumor; D036022:Capsid Proteins; C114580:HPV L1 protein, Human papillomavirus; D009856:Oncogene Proteins, Viral; D050725:Papillomavirus E7 Proteins; D012333:RNA, Messenger; D012367:RNA, Viral