Diagnostic values of P16 and ki67 combined with HPV E6/E7 mRNA in high-grade cervical lesions caused by HPV infection

OBJECTIVE To explore the diagnostic values of P16 and ki67 combined with human papillomavirus (HPV) E6/E7 mRNA detection in high-grade cervical lesions (HSIL) infected with HPV.

METHODS Ninety patients with HPV infected cervical lesions treated at Anqing First People′s Hospital affiliated to Anhui Medical University from Jan. 2019 to Jul. 2023 were selected as the study subjects. Histopathological results were collected, the levels of P16, ki67, HPV E6/E7 mRNA as well as the tissue pathology diagnosis results were compared, and the diagnostic valuse of P16, ki67, HPV E6/E7 mRNA and combined detection for HPV infection of HSIL were analyzed by receiver operating characteristic (ROC) curve. The correlation between P16, ki67 and HPV E6/E7 mRNA in patients with HSIL were analyzed by Spearman correlation.

RESULTS The results of histopathological diagnosis showed that 39 out of 90 patients(43.33%) with HPV infected cervical lesions had no intraepithelial or malignant lesions (NILM). Totally 30 cases of low-grade cervical squamous intraepithelial lesions (LSIL) accounted for 33.33%. Totally 21 cases of highly squamous intraepithelial lesions (HSIL) accounted for 23.33%. P16 was detected 12 cases of LSIL and 13 cases of HSIL. Ki67 detected 13 cases of LSIL and 15 cases of HSIL. HPV E6/E7 mRNA detected 16 cases of LSIL and 16 cases of HSIL; Joint testing detected 24 cases of LSIL and 20 cases of HSIL. The area under the curve (AUC) of P16, ki67, HPV E6/E7 mRNA single and combined detection for the diagnosis of HPV infection with HSIL were 0.592, 0.640, 0.633 and 0.790, respectively, the diagnostic value of the combined test was superior to that of the single test (P < 0.05). P16 expression in HSIL patients was positively correlated with Ki67, HPV E6/E7 mRNA expression (r=0.398, 0.506, all P < 0.05), while Ki67 expression was positively correlated with HPV E6/E7 mRNA expression (r=0.509, P=0.001).

CONCLUSION The expression of P16, ki67 and HPV E6/E7 mRNA in different cervical lesion tissues varies substantially and there are certain correlations among them, which can be used as a reference in the diagnosis of HSIL, while the combined examination of the three indexes has the highest diagnostic value.