Logistic regression analysis of mRNA expression changes and prognosis after cervical surgery

Objective: The aim of this study was to investigate the diagnostic value of HPV (human papillomavirus) E6/E7 mRNA combined with thin-layer liquid-based cytology test (TCT) detection in patients with cervical intraepithelial neoplasia (CIN) in the residual and recurrence of lesions after cervical conization. Methods: A total of 154 patients who had undergone cervical conization and were diagnosed with high-grade cervical intraepithelial neoplasia (CIN 1 and CIN 3) by histopathology and had complete follow-up data were enrolled. TCT, HPV-DNA detection, and HPV E6/E7 mRNA detection combined with TCT detection in 12 months can be used to detect abnormal cytology (>atypical squamous epithelium of undetermined significance). Patients with atypical squamous cell of undetermined significance or high-risk HPV-DNA (+) or HPV E6/E7 mRNA combined with TCT (+) underwent colposcopy and cervical biopsy again for pathological diagnosis. Results: There were 9 cases of residual lesions and 22 cases of recurrence. Thirty of the 57 cases with positive HPV-DNA after surgery were still there or came back. Of the 26 cases with positive HPV E6/E7 mRNA combined with TCT, 24 were still there or came back. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy rate of HPV-DNA detection were 96.8%, 78.0%, 52.6%, 99.0%, and 81.8%, respectively; the sensitivity and specificity of HPV E6/E7 mRNA were combined with TCT detection of sex. Conclusion: HPV E6/E7 mRNA combined with TCT detection can be included in follow-up examinations, which can timely and effectively predict the risk of CIN residual or recurrence after cervical conization and reduce excessive examination and treatment.