The mRNA-HPV Test Utilization in the Follow Up of HPV Related Cervical Lesions

Andrea      Tinelli; Marcello      Guido; Antonella      Zizza; Marcello      Pellegrino; Marilena      Greco; Daniele      Vergara; Ospan      A. Mynbaev; Domenico      Dell'Edera; Antonio      Malvasi

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.

Material & Methods: we investigated, during a 5 years’ study, a cohort of patients divided in: group 1, patients at high risk for HPVinfections, 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.

Keywords: HPV, mRNA, HPV-DNA, cervical cancer, HPV vaccination, cervical Intraepithelial Neoplasia, CIN, cervicocarcinoma in situ, CIS, adenocarcinoma in situ, AIS, nucliSENS easy Q, cervarix