HPV integration: a precise biomarker for detection of residual/recurrent disease after treatment of CIN2-3.

IF 3.1 2区医学 Q3 IMMUNOLOGY Infectious Agents and Cancer Pub Date : 2024-08-08 DOI:10.1186/s13027-024-00600-8

Fanwei Huang, Liang He, Wei Li, Xiaoyuan Huang, Tao Zhang, Munawaer Muaibati, Hu Zhou, Shimin Chen, Wenhui Yang, Fan Yang, Liang Zhuang, Ting Hu

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Abstract

Background: This study aimed to investigate whether persistent human papillomavirus integration at the same loci (PHISL) before and after treatment can predict recurrent/residual disease in women with CIN2-3.

Methods: A total of 151 CIN2-3 women treated with conization between August 2020 and September 2021 were included. To investigate the precision of HPV integration, we further analyzed HPV integration-positive patients. Sensitivity, specificity, positive and negative predictive values (PPV and NPV, respectively), and the Youden index for predicting recurrence/residual disease were calculated.

Results: Among the 151 enrolled CIN2-3 women, 56 were HPV integration-positive and 95 had HPV integration-negative results. Six (10.7%) experienced recurrence among 56 HPV integration-positive patients, which was more than those in HPV integration-negative patients (one patient, 1.1%). In the 56 HPV integration-positive patients, 12 had positive HPV results after treatment, seven had PHISL, and two had positive cone margin. Among the seven patients who tested with PHISL, six (85.7%) had residual/recurrent disease. PHISL was a prominent predictor of persistent/recurrent disease. The HPV test, the HPV integration test, and PHISL all had a sensitivity of 100% and a NPV of 100% for residual/recurrent disease. PHISL showed better specificity (98.0% vs. 82.0%, p = 0.005) and PPV (85.7% vs. 40.0%, p = 0.001) than the HPV test for predicting recurrence.

Conclusions: The HPV-integration-positive CIN2-3 women had much higher relapse rates than HPV-integration-negative CIN2-3 women. The findings indicate that PHISL derived from preoperative and postoperative HPV integration tests may be a precise biomarker for the identification of residual/recurrent CIN 2/3.

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HPV 整合：检测 CIN2-3 治疗后残留/复发疾病的精确生物标志物。

背景：本研究旨在探讨治疗前后人类乳头瘤病毒在同一位点的持续整合（PHISL）能否预测CIN2-3妇女的复发/残留疾病：本研究旨在探讨治疗前后相同位点的持续人乳头瘤病毒整合（PHISL）能否预测CIN2-3女性患者的复发/残留疾病：纳入2020年8月至2021年9月期间接受锥切治疗的151名CIN2-3妇女。为了研究HPV整合的精确性，我们进一步分析了HPV整合阳性患者。我们计算了预测复发/残留疾病的敏感性、特异性、阳性预测值和阴性预测值（分别为 PPV 和 NPV）以及尤登指数：在151名CIN2-3女性患者中，56人HPV整合阳性，95人HPV整合阴性。56 名 HPV 整合阳性患者中有 6 人（10.7%）复发，复发率高于 HPV 整合阴性患者（1 人，1.1%）。在 56 例 HPV 整合阳性患者中，12 例在治疗后出现 HPV 阳性结果，7 例出现 PHISL，2 例出现锥缘阳性。在7名检测出PHISL的患者中，6名（85.7%）有残留/复发疾病。PHISL是预测残留/复发疾病的一个重要指标。HPV检测、HPV整合检测和PHISL对残留/复发疾病的敏感性均为100%，NPV均为100%。在预测复发方面，PHISL 比 HPV 检测显示出更好的特异性（98.0% 对 82.0%，P = 0.005）和 PPV（85.7% 对 40.0%，P = 0.001）：结论：HPV整合阳性CIN2-3女性的复发率远高于HPV整合阴性CIN2-3女性。研究结果表明，术前和术后HPV整合检测得出的PHISL可能是识别残留/复发CIN 2/3的精确生物标志物。

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来源期刊

Infectious Agents and Cancer ONCOLOGY-IMMUNOLOGY

CiteScore

5.80

自引率

2.70%

发文量

期刊介绍： Infectious Agents and Cancer is an open access, peer-reviewed online journal that encompasses all aspects of basic, clinical, epidemiological and translational research providing an insight into the association between chronic infections and cancer. The journal welcomes submissions in the pathogen-related cancer areas and other related topics, in particular: • HPV and anogenital cancers, as well as head and neck cancers; • EBV and Burkitt lymphoma; • HCV/HBV and hepatocellular carcinoma as well as lymphoproliferative diseases; • HHV8 and Kaposi sarcoma; • HTLV and leukemia; • Cancers in Low- and Middle-income countries. The link between infection and cancer has become well established over the past 50 years, and infection-associated cancer contribute up to 16% of cancers in developed countries and 33% in less developed countries. Preventive vaccines have been developed for only two cancer-causing viruses, highlighting both the opportunity to prevent infection-associated cancers by vaccination and the gaps that remain before vaccines can be developed for other cancer-causing agents. These gaps are due to incomplete understanding of the basic biology, natural history, epidemiology of many of the pathogens that cause cancer, the mechanisms they exploit to cause cancer, and how to interrupt progression to cancer in human populations. Early diagnosis or identification of lesions at high risk of progression represent the current most critical research area of the field supported by recent advances in genomics and proteomics technologies.