22 feb. 2011 OUR EXPERIENCE: DETECTION OF E6/E7-MRNA IS BETTER THAN DNA-HPV DETECTION
Izabella Diana Erdelean*, F. Olaru*, D. Grigoraş*, D. Erdelean*,
Diana Maria Anastasiu**, D. Anastasiu**
*County Emergency Hospital Timisoara,Obstetrics and Gynecology Department – University of Medicine and Pharmacy Victor Babes Timişoara
**Obstetrics and Gynecology Discipline III, University of Medicine and Pharmacy Victor Babeş Timişoara
Rezumat
Prezentare. Oncoproteinele E6/E7 produse de HPV cu risc inalt au rol esential in carcinogeneza.Detectia ARNm a acestor oncoproteine demonstreaza activitatea virala si corespund cu initierea si persistenta activitatii precanceroase.Studiile sugereaza ca detectia oncoproteinelor E6/E7-ARNm este un mai bun indicator al progresiei bolii comparativ cu detectia ADN HPV.
ARNm E6/E7 carcinogenic are sensibilitate clinica si valoare predictiv negativa (VPN) asemanatoare cu ADN HPV,dar specificitatea si valoarea predictiv pozitiva sunt net superioare.
Metoda. Va prezentam experienta noastra in decurs de un an,utilizand APTIMA® HPV Assay ,ca metoda de tipizare,aprobata de FDA in 2011.Aceasta metoda foloseste amplificarea secventelor de acizi nucleici bazali,care identifica oncoproteinele E6/E7 si nu virionii HPV ca si in cazul de detectiei ADN.
Rezultate. Utilizand aceasta metoda am obtinut rezultate superioare in stadializarea clinica a displaziilor cervicale si reducerea numarului de cazuri care se prezentau pentru colposcopie.
Abstract – Our experience: Detection of E6/E7-mRNA is better than DNA-HPV detection
Problem statement. E6 and E7 proteins produced by high-risk HPV have an essential role in carcinogenesis. Detection of mRNA for these proteins shows direct viral activity and corresponds to initiation and maintaining of pre-cancerous activity. Studies have suggested that detection of high-risk E6/E7 mRNA may be a better indicator of disease progression than DNA detection. Carcinogenic HPV E6/E7 mRNA may achieve similar clinical sensitivity and Negative Predictive Value (NPV) as carcinogenic HPV DNA, while possibly achieving better clinical specificity and Positive Predictive Value (PPV).
Method. We present our one-year experience using APTIMA® HPV Assay, a method approved by the FDA in 2011. The method used is nucleic acid sequence based amplification (NASBA), which identifies the E6/E7 proteins and not HPV virions like the DNA detection.
Results. We achieved better clinical staging of the dysplasia and reduced the number of cases that were previously referred to colposcopy.
keywords: HPV, E6/E7 mRNA, oncoproteins, cervical lesion, APTIMA® HPV