title: The mRNA-HPV test utilization in the follow up of HPV related cervical lesions.
abstract: The biomolecular follow up of Human Papilloma Virus (HPV) is widely investigated in patients treated for HPV related cervical lesions, since the HPV-mRNA test is more specific and have a higher positive predictive value for CIN2-3 in triage of high risk (HR) women and in follow-up of women treated for CIN2/3.
  
  
  METHODS
  We investigated, during a 5 years' study, a cohort of patients divided in: group 1, patients at high risk for HPV-infections, and group 2, women diagnosed for CIN2/3, Cervicocarcinoma in situ (CIS) and Adenocarcinoma in situ (AIS) and surgically treated. The overall scheduled follow up was repeated each 6 months by: Pap Test, HPV-DNA test, m-RNA-HPV test and, in case of CIN2/3, CIS and AIS, also by colposcopy and biopsy.
  
  
  RESULTS
  The follow up involved a total of 203 women: 85 women with mRNA-HPV positive test and 118 patients surgically treated for CIN2/3, CIS and AIS. In the group 1, the long term follow up detected, after one year, 32 positive mRNA-HR HPV women and, of these, after more than 2 years, 37.5% developed CIN1 and 21.8% developed CIN2/3. Similarly, in the follow up of group two, women with abnormal Pap test showed positivity of mRNA HR-HPV in 71.4% of cases even after 6 months; 65% of these developed a CIN1 within 2.5 years and 20% had CIN2/3 after 2.3 years.
  
  
  CONCLUSIONS
  Study results indicate either that patients with mRNA HR-HPV positive controls, on average, after 12 months are all at risk of progression to CIN1 and CIN2/3, or the higher specificity of mRNA-HPV test than Pap Test in follow up of surgical treated patients. This investigation confirmed a strong association between HR mRNA-HPV presence and risk of neoplastic progression.
authors.affiliation: Department of Obstetric and Gynecology, Vito Fazzi Hospital, Lecce, Italy. andreatinelli@gmail.com
authors.forename: Andrea
authors.initials: A
authors.lastname: Tinelli
authors.forename: Marcello
authors.initials: M
authors.lastname: Guido
authors.forename: Antonella
authors.initials: A
authors.lastname: Zizza
authors.forename: Marcello
authors.initials: M
authors.lastname: Pellegrino
authors.forename: Marilena
authors.initials: M
authors.lastname: Greco
authors.forename: Daniele
authors.initials: D
authors.lastname: Vergara
authors.forename: Ospan A
authors.initials: OA
authors.lastname: Mynbaev
authors.forename: Domenico
authors.initials: D
authors.lastname: Dell' Edera
authors.forename: Antonio
authors.initials: A
authors.lastname: Malvasi
mesh_terms: D000328:Adult; D052685:Alphapapillomavirus / Q000235:genetics / Q000302:isolation & purification*; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D005500:Follow-Up Studies; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D006801:Humans; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D012333:RNA, Messenger / Q000302:isolation & purification*; D012367:RNA, Viral / Q000302:isolation & purification*; D002578:Uterine Cervical Dysplasia / Q000473:pathology* / Q000821:virology
chemical_list: D004279:DNA, Viral; D000068857:Human Papillomavirus Recombinant Vaccine Quadrivalent, Types 6, 11, 16, 18; D053918:Papillomavirus Vaccines; D012333:RNA, Messenger; D012367:RNA, Viral