宫颈细胞HPV E6/E7 mRNA检测在宫颈病变诊断中的价值  

Clinical value of branch-DNA technique for human papillomavirus E6/E7 mRNA detection in cervical lesions

作　　者：严雪梅[1,2] 洪颖[1,3] 

机构地区：[1]南京医科大学鼓楼临床医学院,南京210000 [2]上海梅山医院 [3]南京鼓楼医院

出　　处：《山东医药》2014年第23期60-63,共4页Shandong Medical Journal

基　　金：南京市医学科技发展项目(YKK13189)

摘　　要：目的评价高危型人乳头状瘤病毒(HPV)E6/E7 mRNA检测对宫颈病变的诊断价值。方法 520例患者采用b-DNA技术检测HPV E6/E7 mRNA,并用宫颈液基细胞学(TCT)行宫颈细胞学检查,对其中任何一项阳性者做阴道镜下宫颈活组织检查,以组织病理为金标准,计算HPV E6/E7 mRNA阳性对高级别宫颈上皮内瘤样病变(CIN)、宫颈浸润癌诊断的灵敏度、特异度、阳性预测值、阴性预测值,并与TCT检查进行比较。结果 520例患者中HPV E6/E7 mRNA阳性158例,TCT异常222例。TCT异常者中HPV E6/E7 mRNA阳性率较TCT正常者中HPV E6/E7 mRNA阳性率高(P<0.05)。146例慢性宫颈炎、CINⅠ级患者与124例高级别CIN、宫颈浸润癌患者中HPV E6/E7 mRNA阳性率比较,P<0.05。HPV E6/E7 mRNA阳性对高级别CIN及宫颈浸润癌诊断的灵敏度、特异度、阳性预测值、阴性预测值分别为74.19%、83.33%、58.23%、71.43%,TCT检查分别为81.53%、69.44%、81.45%、92.28%,两者特异度及阳性预测值比较,P均<0.05。结论在宫颈癌筛查中检测高危型HPV E6/E7mRNA对预测高级别CIN,尤其对评估癌症风险有重要的临床价值。Objective To evaluate the clinical value of human papillomavirus （ HPV） E6/E7 mRNA detection in diagnosis of cervical lesions.Methods Totally 520 patients were examined with b-DNA technology to detect HR-HPV E6/E7mRNA and the cervical cytological examination with liquid-based cytology （TCT）.Women with cytologi-cal abnormalities or HR-HPV E6/E7 mRNA positive results underwent colposcopy and cervical biopsy .We compared the sensitivity, specificity, positive predictive value and negative predictive value between the HPV E6/E7mRNA and TCT for the detection of high-grade cervical intraepithelial neoplasias （ CIN） and cervical cancer （ CC） .Results A-mong 520 patients, 158 cases were found HPV E6/E7mRNA positive and 222 cases got TCT abnormal.The positive rate of HPV E6/E7 mRNA with abnormal results in TCT abnormal group was higher than that of the normal group （ P〈0.05） .There was difference in the positive rate of HPV E6/E7mRNA between the group who got chronic cervicitis or low-grade intraepithelial neoplasias （CINⅠ） and the group who got high-grade CIN and CC （P〈0.05）.For the detection of high-grade CIN and CC, the sensitivity of HPVE6/E7 mRNA and TCT was 74.19% and 81.53%, re-spectively; the specificity was 83.33% and 69.44%, respectively; the positive predictive value was 58.23% and 81.45%, respectively; and the negative predictive value was 71.43% and 92.28% respectively.The specificity and positive predictive value was statistically different between the two groups （all P〈0.05）.Conclusion In cervi-cal cancer screening, high-risk HPV E6/E7 mRNA detection in predicting high-grade CIN has high clinical value, es-pecially for assessing the risk of malignancy.

关 键 词：b-DNA技术 人乳头状瘤病毒 E6基因 E7基因 宫颈高度上皮内瘤样病变 

分 类 号：R711.74[医药卫生—妇产科学]