ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology

Anal squamous cell carcinoma is a significant concern among people with HIV (PWH), with high-grade squamous intraepithelial lesions (HSIL) as its precursor. Current screening, primarily based on abnormal anal cytology, often results in unnecessary high-resolution anoscopies (HRA) due to limited spec...

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Autores: Bello-Perez, M, Mascarell, P, Fernández-González, M, García, JA, de la Tabla, AGO, Ledesma, C, de la Rica, A, Galiana, A, López, L, Ocete, MD, Salvador, C, Gimeno, C, García-Abellán, J, Padilla, S, Gutiérrez, F, Masiá, M
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p19319
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/19319
Access Level:acceso abierto
Palabra clave:ADAR1
alternative prediction method
anal HSIL
HPV
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repository_id_str
spelling ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytologyBello-Perez, MMascarell, PFernández-González, MGarcía, JAde la Tabla, AGOLedesma, Cde la Rica, AGaliana, ALópez, LOcete, MDSalvador, CGimeno, CGarcía-Abellán, JPadilla, SGutiérrez, FMasiá, MADAR1alternative prediction methodanal HSILHPVAnal squamous cell carcinoma is a significant concern among people with HIV (PWH), with high-grade squamous intraepithelial lesions (HSIL) as its precursor. Current screening, primarily based on abnormal anal cytology, often results in unnecessary high-resolution anoscopies (HRA) due to limited specificity. This study evaluates whether quantifying Adenosine Deaminase Acting on RNA-1 (ADAR1) mRNA in anal swabs improves HSIL prediction and optimizes HRA selection. In this prospective cohort, HIV-positive adults with abnormal anal cytology underwent HRA. ADAR1 mRNA levels were quantified from anal swabs, and human papillomavirus (HPV) genotyping was performed. The diagnostic performance of ADAR1 mRNA was assessed using receiver operating characteristic (ROC) curve analysis and compared with E6/E7 mRNA detection for high-risk HPV (HR-HPV). HSIL was confirmed by biopsy in 40 of 171 participants (23.4%). HSIL cases had significantly higher ADAR1 mRNA levels (median: 49.4 vs. 4.1 relative units [RU], p < .001) and a greater median number of HPV genotypes (5 vs. 3, p < .001). ROC analysis for ADAR1 mRNA yielded an area under the curve (AUC) of 0.83 (95% CI: 0.75-0.92). At a cut-off of >= 24.8 RU, it demonstrated 73% sensitivity, 92% specificity, 74% positive predictive value, and 92% negative predictive value. Compared to E6/E7 mRNA, ADAR1 mRNA improved screening accuracy (64%-88%) and reduced HRA referrals (77.2%-48.8%). ADAR1 mRNA quantification reliably predicts HSIL in PWH with abnormal anal cytology. Integrating ADAR1 mRNA measurement into anal cancer screening protocols may enhance diagnostic accuracy, reduce unnecessary invasive procedures, and alleviate the burden on limited HRA resources.WILEY2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/19319INTERNATIONAL JOURNAL OF CANCERISSN: 00207136ISSNe: 10970215reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p193192026-06-11T12:45:17Z
dc.title.none.fl_str_mv ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
title ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
spellingShingle ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
Bello-Perez, M
ADAR1
alternative prediction method
anal HSIL
HPV
title_short ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
title_full ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
title_fullStr ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
title_full_unstemmed ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
title_sort ADAR1 mRNA quantification for predicting HSIL in persons with HIV and abnormal anal cytology
dc.creator.none.fl_str_mv Bello-Perez, M
Mascarell, P
Fernández-González, M
García, JA
de la Tabla, AGO
Ledesma, C
de la Rica, A
Galiana, A
López, L
Ocete, MD
Salvador, C
Gimeno, C
García-Abellán, J
Padilla, S
Gutiérrez, F
Masiá, M
author Bello-Perez, M
author_facet Bello-Perez, M
Mascarell, P
Fernández-González, M
García, JA
de la Tabla, AGO
Ledesma, C
de la Rica, A
Galiana, A
López, L
Ocete, MD
Salvador, C
Gimeno, C
García-Abellán, J
Padilla, S
Gutiérrez, F
Masiá, M
author_role author
author2 Mascarell, P
Fernández-González, M
García, JA
de la Tabla, AGO
Ledesma, C
de la Rica, A
Galiana, A
López, L
Ocete, MD
Salvador, C
Gimeno, C
García-Abellán, J
Padilla, S
Gutiérrez, F
Masiá, M
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv ADAR1
alternative prediction method
anal HSIL
HPV
topic ADAR1
alternative prediction method
anal HSIL
HPV
description Anal squamous cell carcinoma is a significant concern among people with HIV (PWH), with high-grade squamous intraepithelial lesions (HSIL) as its precursor. Current screening, primarily based on abnormal anal cytology, often results in unnecessary high-resolution anoscopies (HRA) due to limited specificity. This study evaluates whether quantifying Adenosine Deaminase Acting on RNA-1 (ADAR1) mRNA in anal swabs improves HSIL prediction and optimizes HRA selection. In this prospective cohort, HIV-positive adults with abnormal anal cytology underwent HRA. ADAR1 mRNA levels were quantified from anal swabs, and human papillomavirus (HPV) genotyping was performed. The diagnostic performance of ADAR1 mRNA was assessed using receiver operating characteristic (ROC) curve analysis and compared with E6/E7 mRNA detection for high-risk HPV (HR-HPV). HSIL was confirmed by biopsy in 40 of 171 participants (23.4%). HSIL cases had significantly higher ADAR1 mRNA levels (median: 49.4 vs. 4.1 relative units [RU], p < .001) and a greater median number of HPV genotypes (5 vs. 3, p < .001). ROC analysis for ADAR1 mRNA yielded an area under the curve (AUC) of 0.83 (95% CI: 0.75-0.92). At a cut-off of >= 24.8 RU, it demonstrated 73% sensitivity, 92% specificity, 74% positive predictive value, and 92% negative predictive value. Compared to E6/E7 mRNA, ADAR1 mRNA improved screening accuracy (64%-88%) and reduced HRA referrals (77.2%-48.8%). ADAR1 mRNA quantification reliably predicts HSIL in PWH with abnormal anal cytology. Integrating ADAR1 mRNA measurement into anal cancer screening protocols may enhance diagnostic accuracy, reduce unnecessary invasive procedures, and alleviate the burden on limited HRA resources.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/19319
url https://fisabio.portalinvestigacion.com/publicaciones/19319
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv WILEY
publisher.none.fl_str_mv WILEY
dc.source.none.fl_str_mv INTERNATIONAL JOURNAL OF CANCER
ISSN: 00207136
ISSNe: 10970215
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15.81155

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