Accuracy of Mrna Hpv Tests As A Predictor of Recurrence of Precursor Lesions and Cervical Cancer After Conization: A Systematic Review and Meta-Analysis

Abstract

Objective: This systematic review evaluates the accuracy of mRNA HPV biomarker for the identification of cervical intra-epithelial neoplasia (CIN) or cervical cancer during a follow-up after conization, taking histopathology as reference standard. Methods: A search of electronic databases was performed, for studies published until June 2018. As results, after screening, five studies including 1148 patients met the inclusion criteria. Dichotomization was performed by CIN2+ versus CIN1-. By analyzing all five studies, a sensitivity of 62.4% (95% CI: 54.8–69.7), specificity of 91.9% (95% CI: 90.0–93.5) and area under the curve of 0.5685 were revealed. Conclusion: mRNA HPV assay presents a high specificity and is an adequate tool for cervical cancer screening in the follow-up after conization.

Keywords:

• biomarkers
• cervical cancer
• CIN
• conization
• diagnostic systematic review
• HSIL
• meta-analysis
• mRNA HPV
• recurrence
• screening

Author contributions

ACL Macedo, CLM Borba, DV Bavaresco, AJ Grande and MI Rosa designed the study and wrote the protocol. ACL Macedo, CLM Borba and MI Rosa managed the literature searches and screening. ACL Macedo, CLM Borba, AJ Grande and MI Rosa contributed to analyses and statistical interpretation. ACL Macedo, CLM Borba, DV Bavaresco, AJ Grande and MI Rosa wrote the first draft of the manuscript. All authors contributed and have approved the final manuscript.

Financial & competing interests disclosure

University of Southern Santa Catarina (UNESC), SC, Brazil. MI Rosa is a recipient of a CNPQ (Brazil) Productivity Fellowship. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Additional information

Funding

University of Southern Santa Catarina (UNESC), SC, Brazil. MI Rosa is a recipient of a CNPQ (Brazil) Productivity Fellowship. This study was financed in part by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior – Brasil (CAPES) – Finance Code 001. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.