Detection of HPV E6/E7 mRNA in the diagnosis of cervical cancer and precancerous lesions after kidney transplantation

Objective: To explore the value of human papillomavirus (HPV) E6/E7 mRNA detection in the diagnosis of cervical cancer and its precancerous lesions after kidney transplantation. Methods: One hundred and sixty-six women who underwent cervical cancer screening after kidney transplantation were selected and received thinprep cytology test (TCT), HPV DNA and HPV E6/E7 mRNA tests. A biopsy under colposcopy was performed for those with suspicious test results. The positive rates of TCT, HPV DNA and HPV E6/E7 mRNA expressions in patients with different biopsy pathological grades, the positive rates of HPV E6/E7 mRNA in TCT and HPV DNA positive patients were compared. Besides, the relationship between the results of the three detections and the pathological results of cervical biopsy as well as the diagnostic efficacy of cervical cancer and its precancerous lesions were compared. Results: Among the 166 women undergoing cervical cancer screening, 87 cases received histopathological biopsy, of which, the positive expression rates of HPV E6/E7 mRNA in the negative, cervical intraepithelial neoplasia (CIN) I, CIN II, CIN III and invasive carcinoma (ICC) patients were 51.43%, 54.55%, 66.67%, 81.82% and 100.00%, respectively. The positive expression rates of HPV E6/E7 mRNA in TCT and HPV DNA-positive patients were 47.50% and 51.96%, respectively; those rates for diagnosis of >= CIN II were significantly greater than that of <= CIN I (both P<0.01). Receiver operating characteristic curve revealed that the areas under the concentration-time curve of TCT, HPV DNA and HPV E6/E7 mRNA detection for cervical cancer and precancerous lesions were 0.723, 0.833, 0.929, respectively. Their sensibilities were 76.89%, 83.30% and 92.38%, and their specificities were 77.04%, 88.47% and 94.47%, respectively. Conclusion: HPV E6/E7 mRNA detection effectively improves the diagnostic sensitivity and specificity of cervical cancer and precancerous lesions, thereby avoiding over-examination and over-treatment.