title: Human papillomavirus E6/E7 mRNA testing has higher specificity than liquid-based DNA testing in the evaluation of cervical intraepithelial neoplasia.
abstract: OBJECTIVE
  To examine the specificity of human papillomavirus (HPV) E6/E7 mRNA testing for intraepithelial precursor lesions and invasive carcinoma of the uterine cervix in 358 women and compare the results with those of the most widely used DNA technique.
  
  
  METHODS
  For HPV E6/E7 mRNA testing an amplification assay was used. For DNA determination a hybridization assay was applied. Both techniques were used simultaneously in patients with normal morphology (150), cervical intraepithelial neoplasia (173) and invasive carcinoma of the cervix (35).
  
  
  RESULTS
  HPV DNA positivity rates were significantly higher than E6/E7 mRNA in women with normal morphology (21-7%), cervical intraepithelial neoplasia (CIN) 1 and 2 (75-43%), and CIN 3 (93-63%). In invasive cervical carcinoma, both methods tested equally high (94% vs. 97%). Considering that E6/E7 up-regulation represents the initial step in cervical carcinogenesis, it can be assumed that this test allows a more specific detection of lesions with a potential for progression.
  
  
  CONCLUSIONS
  HPV E6/E7 mRNA may serve as a more specific discriminator between transient cervical dysplasias and potentially progressive lesions. Accordingly, testing for high-risk HPV E6/E7 mRNA might reduce the psychologic burden associated with HPV-DNA testing.
authors.affiliation: Institute of Pathology, University of Witten/Herdecke, Wuppertal, Germany.
authors.forename: Jochen
authors.initials: J
authors.lastname: Möckel
authors.forename: Jens
authors.initials: J
authors.lastname: Quaas
authors.forename: Helga
authors.initials: H
authors.lastname: Meisel
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Endres
authors.forename: Volker
authors.initials: V
authors.lastname: Schneider
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015344:DNA Probes, HPV / Q000235:genetics; D004279:DNA, Viral / Q000032:analysis* / Q000235:genetics; D005260:Female; D005434:Flow Cytometry / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009856:Oncogene Proteins, Viral / Q000235:genetics*; D050725:Papillomavirus E7 Proteins / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000821:virology; D012333:RNA, Messenger / Q000032:analysis* / Q000235:genetics; D012680:Sensitivity and Specificity; D017422:Sequence Analysis, DNA; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000821:virology*; D055815:Young Adult
chemical_list: D015344:DNA Probes, HPV; D004279:DNA, Viral; C118860:E6 protein, Human papillomavirus type 6; D009856:Oncogene Proteins, Viral; D050725:Papillomavirus E7 Proteins; D012333:RNA, Messenger