The influence of biopsy in cervical high-grade squamous intraepithelial lesion, evaluated by HPV E6/E7 mRNA, Pap test, and conization results

Objective: To evaluate the influence of biopsy on cervical intraepithelial neoplasia (CIN). Materials and Methods: A study was conducted involving 124 women underwent colposcopy-guided biopsy. At the first appointment, the women answered the survey questionnaire, cervical samples were collected for Papanicolaou (Pap) testing and the HPV E6/E7 mRNA test. At the second appointment at three to four months after the first, samples were collected from 81 patients with indications for conization, Pap test, and HPV E6/E7 mRNA testing before they underwent the procedure. PCR was used to detect HPV mRNA. The percentage of negative results before and after the biopsy was evaluated. The agreement between the tests results was evaluated using Cohen's kappa. Results: Sixty-two patients (76.4%) were between 21 and 40 years of age, 35 (43.2%) had four or more pregnancies, 41 (50.5%) had their sexual debut at 16 years of age or more, and 52 patients (64.2%) had undergone five or more Pap tests. The initial biopsy was negative for CIN2/3 in 14 (12.3%) patients; however, all patients were submitted to conization. Among those women with biopsy showing CIN2/3 (66 [81.5%]), 7.41% showed CIN1 and 14.81% were negative in the conization (kappa = 0.2052). The E6/E7 test performed before and after biopsy showed the best level of agreement by the kappa coefficient (0.7491) Conclusions: A higher percentage of negative results were observed in the histopathology, cytopathology, and E6/E7 after biopsy, suggesting that biopsy could affect the regression of CIN.

HPV; Cervix; mRNA E6/E7; CIN.

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