高危型HPV E6/E7 mRNA检测对高级别宫颈病变的诊断价值  

Clinical value of high-risk HPV E6/E7 mRNA in detection of high-grade cervical lesions

作　　者：郑智 曹晓恩[2] 张红萍 

机构地区：[1]温州市人民医院妇产科,325000 [2]中国人民解放军第118医院普外科

出　　处：《浙江医学》2016年第14期1154-1157,共4页Zhejiang Medical Journal

基　　金：温州市公益性科技计划项目(Y20150200)

摘　　要：目的探讨高危型人乳头瘤病毒(HPV)E6/E7 mRNA检测对高级别宫颈病变的临床诊断价值。方法选取2014年8月至2015年3月在妇科门诊及住院的疑似宫颈病变患者311例,均行宫颈脱落细胞的薄层液基细胞学检查、HPV DNA分型检测和高危型HPV E6/E7 mRNA检测,对其中任意一项或多项结果阳性者行阴道镜下宫颈活组织检查和组织病理学检查。以病理报告为金标准,进行统计学分析。结果慢性宫颈炎组中HPV DNA分型检测检出率(29.4%)高于高危型HPV E6/E7 mR NA(17.5%),差异有统计学意义(P<0.05)。高危型HPV E6/E7 mRNA检测预测高级别宫颈病变的特异度(73.4%)高于HPV DNA分型检测(59.8%),差异有统计学意义(P<0.05)。高危型HPV E6/E7 mRNA检测诊断高级别宫颈病变ROC曲线下面积(0.816)大于HPV DNA分型检测(0.710),差异有统计学意义(P<0.05)。结论与HPV DNA分型检测相比,高危型HPV E6/E7 mRNA检测预测高级别宫颈病变具有更好的特异度,其诊断效能更佳。Objective To assess the clinical value of high-risk human papilloma virus（HPV） E6/E7 mR NA in detection o high-grade cervical lesions（cervical intraepithelial neoplasm II, III and cervical cancer）. M ethods A total of 311 patients with suspected cervical lesions were visiting our hospital between August 2014 and March 2015 were included. Thinprep cytology tes（TCT） of exfoliated cervical cells, HPV DNA classification detection and high-risk HPV E6/E7 mR NA detection were performed for all patients; patients with positive results of one or multiple tests underwent colposcopic cervical biopsy and histopathologica examination. With pathological result as the gold standard, the clinical value of two tests was analyzed and compared. Results The positive rate of chronic cervicitis with HPV DNA classification was higher than that with high-risk HPV E6/E7 mR NA detection（29.4% vs. 17.5%, P〈 0.05）. The specificity of high-risk HPV E6/E7 mR NA test in detecting high-grade cervical lesions was higher than that of HPV DNA classification test（73.4% vs 59.8%, P〈0.05）. The area under the ROC curve of high-risk HPV E6/E7 mR NA detection in diagnosing high-grade cervical lesions was larger than that of HPV DNA classification test（0.816 vs. 0.710P〈0.05）. Conclusion Compared to HPV DNA classification test, high-risk HPV E6/E7 mR NA detection has better clinical value in prediction of high-grade cervical lesions.

关 键 词：人乳头瘤病毒 E6/E7mRNA DNA 宫颈上皮内瘤样病变 宫颈肿瘤 

分 类 号：R737.33[医药卫生—肿瘤]