人乳头瘤病毒E6/E7mRNA检测在宫颈病变筛查中的应用价值  

The application value of human papillomavirus E6/E7 mRNA detection in cervical lesions screening

作　　者：张生枝[1,2] 邵华江[2] 马建婷[2] 

机构地区：[1]宁波大学医学院,浙江宁波315211 [2]宁波大学医学院附属阳明医院妇产科,浙江余姚315400

出　　处：《中国实验诊断学》2014年第4期582-585,共4页Chinese Journal of Laboratory Diagnosis

摘　　要：目的探讨人乳头瘤病毒(HPV)E6/E7mRNA检测在宫颈病变筛查中的应用价值。方法 2012年6月至2013年4月在余姚市人民医院因宫颈炎症、阴道异常出血或排液的720例门诊患者行宫颈TCT和HPV DNA检测,对TCT结果≥ASC-US或(和)高危HPV DNA阳性者行宫颈HPV E6/E7mRNA检测和组织病理学检查。以病理学结果为标准,与HPV DNA检测相比较,评价HPV E6/E7mRNA检测对CIN2+诊断价值,并用受试者工作特征(ROC)曲线评价其准确性。结果在CIN和宫颈浸润癌中,HPV E6/E7mRNA总体阳性率为78.7%,低于HPV DNA总体阳性率(92.6%),差异有统计学意义(P<0.001)。HPV E6/E7mRNA检测诊断CIN2+的灵敏度为83.0%,低于HPV DNA(94.5%),差异有统计学意义(P<0.01);特异度为51.1%,高于HPV DNA(22.8%),差异有统计学意义(P<0.001)。HPV E6/E7mRNA、HPV DNA对诊断CIN2+的ROC曲线下面积分别为0.670、0.587,HPV E6/E7mRNA检测对CIN2+的诊断的准确性高于HPV DNA,差异有统计学意义(P<0.01)。结论 HPV E6/E7mRNA检测诊断CIN2+特异度和准确性高于HPV DNA,对宫颈病变的筛查有一定应用价值。Objective To investigate the application value of detecting human papillomavirus（HPV）E6/E7 mRNA as a diagnose test for cervical lesions screening.Methods From June 2012 to April 2013,a total of 720 gynecological outpatients in Yangming Hospital affiliated to Medical School of Ningbo University,who had cervical inflammation,ab-normal vaginal bleeding or discharge ,received TCT and HPV DNA tests,and for those whose TCT≥ASC-US or/and high-risk HPV DNA-positive had HPV E6/E7 mRNA detection and histopathological examination.With the pathology results as the standard,the value of HPV E6/E7 mRNA detection for the diagnosis of CIN2＋ was evaluated by com-parison with the HPV DNA test,and its accuracy was also evaluated by the receiver-operating characteristic （ROC） curve.Results In CIN and invasive cervical cancer,the positive rate of HPV E6/E7 mRNA was 78.7%,lower than that of HPV DNA （92.6%）,the difference was statistically significant （P 〈0.001）.The sensitivity of HPV E6/E7 mRNA detection for diagnosis of CIN2＋ was 83.0%,lower than that of HPV DNA （94.5%）,the difference was sta-tistically significant （P 〈0.01）.The specificity was 51.1%,higher than that of HPV DNA （22.8%）,the difference was statistically significant （P 〈0.001）.Through the areas of ROC for HPV E6/E7 mRNA and HPV DNA were 0. 670 and 0.587 respectively ,so the accuracy of HPV E6/E7 mRNA detection for CIN2＋ was higher than that of HPV DNA,the difference was statistically significant （P 〈0.01）.Conclusion The specificity and accuracy of HPV E6/E7 mRNA detection are higher than those of HPV DNA for diaganosis of CIN2＋,so HPV E6/E7 mRNA detection has a certain application value for cervical lesions screening.

关 键 词：E6 E7 mRNA 人乳头瘤病毒 DNA 人乳头瘤病毒 宫颈病变 

分 类 号：R737.33[医药卫生—肿瘤]