HPV E6/E7 mRNA检测联合液基细胞学检查对宫颈上皮内瘤变Ⅱ～Ⅲ级术后的随访价值  

Value of HPV E6/E7 mRNA combined with liquid-based cytology examination for patients with cervical intraepithelial neoplasias grade Ⅱ～Ⅲ

作　　者：李梅[1] 杨素芬[1] 叶瑞勉 张燕科[1] 

机构地区：[1]宁波大学医学院附属医院妇科,浙江宁波315020

出　　处：《全科医学临床与教育》2015年第3期272-274,277,共4页Clinical Education of General Practice

基　　金：刘孔爱菊基金(2011年)

摘　　要：目的探讨HPV E6/E7 mRNA联合液基细胞学检查(TCT)在宫颈上皮内瘤变(CIN)Ⅱ~Ⅲ级术后复发的诊断价值。方法分析358例CIN II^III级患者的临床资料,并对其进行随访,术后3、6、12、18、24个月行TCT、高危型人乳头状瘤病毒(HR-HPV)DNA及HPV E6/E7 mRNA。在术后第12月随访时,对这三项检测中至少一项阳性的患者行组织病理学检查,评价宫颈病变复发情况。结果术后3~18月HR-HPV DNA、HPV E6/E7 mRNA阴性率呈逐渐升高趋势,但术后24月HR-HPV DNA较术后18月略有下降。TCT阴性率在术后12月最低,术后24月最高。TCT、HPV E6/E7 mRNA联合检测与TCT、HR-HPV DNA联合检测的灵敏度比较,差异无统计学意义(χ2=2.50,P>0.05),而TCT、HPV E6/E7 mRNA联合检测的特异性较TCT、HR-HPV DNA联合检测高,差异有统计学意义(χ2=18.60,P<0.05)。结论 HPV E6/E7 mRNA联合TCT检测可提高CINⅡ~Ⅲ级患者术后复发的诊断准确性。Objective To evaluate the diagnostic value of HPV E6/E7 mRNA combined with liquid-based cytology ex-amination for relapsing in patients with cervical intraepithelial neoplasias（CIN） grade Ⅱ～Ⅲ. Methods The clinical datas of 358 patients with CIN gradeⅡ～Ⅲwere analyzed. Postoperative follow-up was performed with liquid-based cytology test （TCT）, High-risk HPV DNA （HR-HPV DNA） detection and HPV E6/E7mRNA detection at the 3rd, 6th, 12th, 18th, 24th month period. At 12th month of follow-up, histopathological examination was performed under colposcopy to evaluate recur-rence of cervical lesions in patients with at least one test was positive of TCT, HR-HPV DNA and HPV E6/E7mRNA de-tections. Results The negative rates of HR-HPV DNA and HPV E6/E7mRNA from the 3rd to 18th month showed a gradu-ally increased tendency but HR-HPV DNA at 24th month was lower than 18th. The negative rate of TCT at 12th month was lowest while was highest at 24th month. There was no statistical difference of sensitivity between TCT combined with HR-HPV DNA detection and TCT combined with HPV E6/E7 mRNA detection （χ2=2.50, P〉0.05）. Compared with TCT com-bined with HR-HPV DNA detection, the specificity of TCT combined with HPV E6/E7 mRNA detection was significantly higher（χ2=18.60, P〈0.05） . Conclusions HPV E6/E7 mRNA combined with TCT detection can improve diagnostic accu-racy of postoperative recurrence of patients with CIN gradeⅡ～Ⅲ.

关 键 词：人乳头状瘤病毒E6/E7 mRNA 高危型人乳头状瘤病毒-DNA 液基细胞学检查 宫颈上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]