Assessment of the diagnostic value and prognosis of different detection markers in endocervical adenocarcinoma.
10.3760/cma.j.cn112152-20220705-00473
- VernacularTitle:不同检测标志物在宫颈腺癌中的诊断和预后预测价值评估
- Author:
Chang Ning ZHANG
1
;
Xiao Yang LIU
2
;
Qing LI
3
;
Yi Zhe SONG
4
;
Bin LIU
4
;
Jian YIN
5
;
Jing Hong YANG
6
;
Li ZHONG
1
;
Li SUN
7
;
Xun ZHANG
4
;
Wen CHEN
4
Author Information
1. School of Life Science, Hebei University, Baoding 071002, China.
2. Department of Pathology, Peking University, People' Hospital, Beijing 100044, China.
3. Department of Pathology, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100021, China.
4. Department of Cancer Epidemiology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100021, China.
5. School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China.
6. Department of Gynecology, Mianyang Maternity & Child Healthcare Hospital, Mianyang 621000, China.
7. National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China.
- Publication Type:Journal Article
- Keywords:
E6/E7 mRNA in situ hybridization;
Endocervical adenocarcinoma;
Human papillomavirus;
Laser capture microdissection;
Prognosis;
Whole tissue section-polymerase chain reaction
- MeSH:
Female;
Humans;
Papillomavirus Infections/diagnosis*;
Retrospective Studies;
Uterine Cervical Neoplasms/pathology*;
Prognosis;
Oncogene Proteins, Viral/genetics*;
Human Papillomavirus Viruses;
Adenocarcinoma/pathology*;
RNA, Messenger/genetics*;
Papillomaviridae/genetics*;
RNA, Viral/genetics*
- From:
Chinese Journal of Oncology
2023;45(5):402-409
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To study the diagnostic value of different detection markers in histological categories of endocervical adenocarcinoma (ECA), and their assessment of patient prognosis. Methods: A retrospective study of 54 patients with ECA in the Cancer Hospital, Chinese Academy of Medical Sciences from 2005-2010 were performed. The cases of ECA were classified into two categories, namely human papillomavirus-associated adenocarcinoma (HPVA) and non-human papillomavirus-associated adenocarcinoma (NHPVA), based on the 2018 international endocervical adenocarcinoma criteria and classification (IECC). To detect HR-HPV DNA and HR-HPV E6/E7 mRNA in all patients, we used whole tissue section PCR (WTS-PCR) and HPV E6/E7 mRNA in situ hybridization (ISH) techniques, respectively. Additionally, we performed Laser microdissection PCR (LCM-PCR) on 15 randomly selected HR-HPV DNA-positive cases to confirm the accuracy of the above two assays in identifying ECA lesions. Receiver operating characteristic (ROC) curves were used to analyze the efficacy of markers to identify HPVA and NHPVA. Univariate and multifactorial Cox proportional risk model regression analyses were performed for factors influencing ECA patients' prognoses. Results: Of the 54 patients with ECA, 30 were HPVA and 24 were NHPVA. A total of 96.7% (29/30) of HPVA patients were positive for HR-HPV DNA and 63.3% (19/30) for HR-HPV E6/E7 mRNA, and 33.3% (8/24) of NHPVA patients were positive for HR-HPV DNA and HR-HPV E6/E7 mRNA was not detected (0/24), and the differences were statistically significant (P<0.001). LCM-PCR showed that five patients were positive for HR-HPV DNA in the area of glandular epithelial lesions and others were negative, which was in good agreement with the E6/E7 mRNA ISH assay (Kappa=0.842, P=0.001). Analysis of the ROC results showed that the AUC of HR-HPV DNA, HR-HPV E6/E7 mRNA, and p16 to identify HPVA and NHPVA were 0.817, 0.817, and 0.692, respectively, with sensitivities of 96.7%, 63.3%, and 80.0% and specificities of 66.7%, 100.0%, and 58.3%, respectively. HR-HPV DNA identified HPVA and NHPVA with higher AUC than p16 (P=0.044). The difference in survival rates between HR-HPV DNA (WTS-PCR assay) positive and negative patients was not statistically significant (P=0.156), while the difference in survival rates between HR-HPV E6/E7 mRNA positive and negative patients, and p16 positive and negative patients were statistically significant (both P<0.05). Multifactorial Cox regression analysis showed that International Federation of Obstetrics and Gynecology (FIGO) staging (HR=19.875, 95% CI: 1.526-258.833) and parametrial involvement (HR=14.032, 95% CI: 1.281-153.761) were independent factors influencing the prognosis of patients with ECA. Conclusions: HR-HPV E6/E7 mRNA is more reflective of HPV infection in ECA tissue. The efficacy of HR-HPV E6/E7 mRNA and HR-HPV DNA (WTS-PCR assay) in identifying HPVA and NHPVA is similar, with higher sensitivity of HR-HPV DNA and higher specificity of HR-HPV E6/E7 mRNA. HR-HPV DNA is more effective than p16 in identifying HPVA and NHPVA. HPV E6/E7 mRNA and p16 positive ECA patients have better survival rates than negative.
