宫颈细胞HPV E6/E7 mRNA检测在宫颈病变诊断中的价值研究  

Diagnostic value of the HPV E6/E7 mRNA of cervical cells in the detection of cervical lesions

作　　者：蒙志平 黎勇明[1] 杨玲[1] 吴险[1] 梁金艳[1] 林丽文[1] 梁婷[1] 黄川英[1] 

机构地区：[1]广西壮族自治区贵港市人民医院检验科,537100

出　　处：《国际检验医学杂志》2016年第21期2987-2989,共3页International Journal of Laboratory Medicine

基　　金：广西壮族自治区贵港市科学技术局项目(140837)

摘　　要：目的探讨宫颈细胞人乳头状瘤病毒(HPV)E6/E7mRNA检测对于诊断宫颈病变的应用价值。方法选取2014年10月至2015年10月在该院妇产科因宫颈炎性反应、阴道异常出血或排液门诊患者就诊的407例患者,行新柏氏液基细胞学检测(TCT)和HPV E6/E7mRNA检测,对TCT结果异常的34例患者行病理科组织病理学检查,以病理报告为"金标准"。统计分析HPV E6/E7mRNA检测对宫颈病变的应用价值。结果 TCT检测出异常患者34例,占总患者数的8.35%,无上皮内瘤变或恶性病变(NILM)患者373例,占总患者数的91.65%;HPV E6/E7mRNA检测异常患者87例,占总患者数的21.37%。2组差异有统计学意义(P<0.05)。TCT不同结果与HPV E6/E7mRNA拷贝数的比较表明,从意义不明的不典型鳞状细胞(ASCUS)到不能排除高度上皮内病变的不典型鳞状上皮(ASC-H)、鳞状上皮内低度病变(LSIL)、鳞状上皮内高度病变(HSIL),随着细胞学诊断级别的升高,HPV E6/E7mRNA阳性率同步升高(P<0.05)。结论宫颈细胞HPV E6/E7mRNA诊断可较大程度降低过度检查和治疗的可能性,诊断宫颈上皮内瘤变(CIN)Ⅱ+的准确性较高,可降低宫颈病变的漏诊率,其对于宫颈病变的诊断有较高的临床应用价值。Objective To investigate the diagnostic value of the human papilloma virus（HPV）E6/E7 mRNA of cervical cells in the detection of cervical lesions.Methods A total of 407 patients with cervical inflammation and abnormal vaginal bleeding were selected from October 2014 to October 2015 in the department of obstetrics and gynecology.By thinprep cytologic test（TCT）,cervical cells of the patients were detected.And the E6/E7 mRNA of cervical cells was also detected.In addition,abnormal TCT results of34 patients were inspected by pathological examination again,and the results of the pathological examination were the gold standard.Value of HPV E6/E7 mRNA in detection of cervical lesions was analyzed.Results There were 34 cases having abnormal TCT results,which accounted for 8.35%in all the patients.There were 373 cases without intraepithelial neoplasia or malignant lesion,which accounted for 91.65%in all the patients.And 87 cases had abnormal HPV E6/E7 mRNA detection results,which accounted for 21.37%.The difference between the two groups had statistical significance（P〈0.05）.Along with the levels of cytohistologic diagnosis,the positive rates of the HPV E6/E7 mRNA in the testing of atypical squamous cells of undetermined significance（ASCUS）,atypical squamous cells of highly intraepithelial lesion（ASC-H）,low-grade squamous intraepithelial lesion（LSIL）and highgrade squamous intraepithelial lesion（HSIL）were also increased（P〈0.05）.Conclusion Cervical HPV E6/E7 mRNA detection may reduce the excessive examination and treatment and it has the higher accuracy of cervical intraepithelial neoplasia（CIN）Ⅱ＋,at the same time,it can reduce the rate of misdiagnosis of cervical lesions.The method has higher clinical value in the diagnosis of cervical lesions.

关 键 词：宫颈病变 人乳头状瘤病毒 宫颈活检 诊断价值 

分 类 号：R737.33[医药卫生—肿瘤] R730.43[医药卫生—临床医学]