HPV E6/E7联合液基细胞学检查在宫颈癌前病变筛查中的意义  

Clinical significance of HPV E6/E7 mRNA test combining TCT test to detect early cervical dysplasia

作　　者：夏作利[1] 陈国荣[2] 潘丹[1] 林萍[1] 金茹[1] XIA Zuo Li CHEN Guo-Rong PAN Dan LIN Pin JIN Ru(Department of Pathology, Wenzhou People＇s Hospital, Wenzhou 325000, Chin)

机构地区：[1]温州医科大学温州市第三临床学院病理科,325000 [2]温州医科大学附属第一医院病理科,325000

出　　处：《实用医学杂志》2016年第18期3053-3056,共4页The Journal of Practical Medicine

基　　金：温州市卫生局课题(编号:2016B04)

摘　　要：目的:探讨宫颈E6/E7检测及液基细胞学检查两种方法联合检测在宫颈癌筛查中的意义。方法:筛选温州市人民医院2014年6月至2015年9月间同时行液基细胞学、E6/E7及组织学检查的病例377例,以组织学检查作为金标准。结果 :联合检测可以提高检查的敏感性,对低级别鳞状上皮内病变的敏感性为94.41%;对高级别鳞状上皮内病变的敏感性为96.36%。E6/E7检查对高级别鳞状上皮内病变诊断的敏感性为90%,特异性为60.67%,PPV和NPV分别为48.53%、92.49%。液基细胞学对高级别鳞状上皮内病变诊断的敏感性为72.73%,特异性为75.28%,PPV和NPV分别为54.79%、87.01%。结论:E6/E7检查的敏感性比液基细胞学高,而液基细胞学检测特异性较高。E6/E7检测NPV的意义大于液基细胞学。E6/E7及液基细胞学两种方法联合检测可以提高宫颈癌前病变筛查的敏感性,而特异性相似。Objective To investigate the value of HPV E6/E7 mRNA test combining liquid-based cytology test in cervical cancer screening. Methods A total of 377 samples from Wenzhou People＇s Hospital from June 2014 to September 2015 were collected and screened by HPV E6/E7 mRNA test combining with liquid-based cytology test, and the results was compared with the findings from the gold criteria of histology and pathology. Results The combination of HPV E6/E7 mRNA test and liquid-based cytology test can enhance the testing sensitivity and specificity. The sensitivity of the combination of HPV E6/E7 mRNA test and liquid-based cytology test for the diagnosis of LSIL was 94.41%, and that for the diagnosis of HSIL was 96.36%. Based on the gold criteria of histology and pathology, the sensitivity, specificity, positive-predictlve value and negative predictive value of HPV E6/E7 mRNA test for the diagnosis of HS1L was 90%, 60.67%, 48.53% and 92.49% respectively. The sensitivity, specificity, positive-predictive value and negative- predictive value of liquid-based cytology test for the diagnosis of HSIL was 72.73%, 75.28%, 54.79% and 87.01% respectively. Conclusions The sensitivity of HP~ E6/E7 mRNA test is superior to that of liquid-based cytology test, while the specificity of HPV E6/E7 mRNA test is inferior to that of liquid-based cytology test. The negative predictive value of HPV E6/E7 mRNA test is more meaningful than that of liquid-based cytology test. The combination of HPV E6/E7 mRNA test and liquid-based cytology test can enhance the testing sensitivity, but it does not increase the specificity.

关 键 词：宫颈癌前病变 HPV E6/E7 MRNA检测 低级别鳞状上皮内病变 高级别鳞状上皮内病变 液基细胞学 

分 类 号：R737.33[医药卫生—肿瘤]