高危型人乳头瘤病毒E6/E7 mRNA联合液基细胞学检查在宫颈病变诊断中的应用  

The application of HR-HPV E6/E7 mRNA detection with thinprep cytologic test for cervical lesions diagnosis

作　　者：叶丽君[1] 喻长法[2] 蔡莎莎[2] 李杰[2] 付承林[3] 严德文 YE Li-jun YU Chang-fa CAI Sha-sha LI Jie FU Cheng-lin YAN De-wen(The First People Hospital of Taizhou, Taizhou, Zhejiang Province 318020, China)

机构地区：[1]浙江省台州市第一人民医院输血科,浙江省台州318020 [2]浙江省台州市第一人民医院检验科 [3]浙江省台州市第一人民医院病理科 [4]浙江省台州市第一人民医院妇科

出　　处：《中国慢性病预防与控制》2017年第7期499-501,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：浙江省台州市科技局课题资助项目(1601KY31)

摘　　要：目的探讨高危型人乳头瘤病毒E6/E7 mRNA(HR-HPV E6/E7 mRNA)联合液基细胞学检查(TCT)在宫颈病变诊断中的应用价值。方法选择2015年6月至2016年5月在台州市第一人民医院妇科进行宫颈病变检查的280例女性为研究对象,其中炎症组183例,宫颈上皮内瘤变Ⅰ(CINⅠ)组42例,CINⅡ组33例,CINⅢ组15例和宫颈癌(SCC)组7例,并进行HR-HPV E6/E7 mRNA、高危型人乳头瘤病毒DNA(HR-HPV DNA)检测和病理活检,以病理活检为金标准,比较各组间HR-HPV E6/E7 mRNA和HR-HPV DNA的阳性检出率。用SPSS 16.0统计软件进行分析,组间比较用χ~2检验或Fisher确切概率法检验。结果 CIN组和SCC组HR-HPV E6/E7 mRNA、HR-HPV DNA阳性率(CINⅠ组分别为52.38%和64.29%,CINⅡ组分别为84.85%和87.88%,CINⅢ组分别为93.33%和93.33%,SCC组分别为100.00%和100.00%)均显著高于炎症组(分别为14.75%和34.97%),CINⅡ、CINⅢ和SCC组阳性率显著高于CINⅠ组,差异均有统计学意义(P<0.05)。炎症组HR-HPV DNA阳性率显著高于HR-HPV E6/E7 mRNA,差异有统计学意义(P<0.05)。HRHPV E6/E7 mRNA特异度和阳性预测值显著高于HR-HPV DNA,差异有统计学意义(P<0.01)。单独使用HR-HPV E6/E7mRNA检测宫颈病变灵敏度为73.20%,单独使用TCT检测灵敏度为81.44%,两者串联检测灵敏度为92.78%,显著高于单独检测,差异有统计学意义(P<0.05)。结论 HR-HPV E6/E7 mRNA检测在CINⅡ、CINⅢ和SCC组中具有较高的敏感度和特异度,HR-HPV E6/E7 mRNA联合TCT检测可提高宫颈病变检出率。Objective To explore the application value of HR-HPV E6/E7 mRNA detection with thinprep cytologic test（TCT） for cervical lesions diagnosis. Methods The specimens of 280 female cases with cervical lesions were selected as the subjects, which included the inflammation group（183 cases）, cervical intraepithelial neoplasia Ⅰ（CINⅠ） group（42 cases）, CINⅡ group（33cases）, CINⅢ group（15 cases） and cervical carcinoma（SCC） group（7 cases）. HR-HPV E6/E7 mRNA, HR-HPV DNA and pathological biopsy were detected for all subjects. The pathological biopsy served as the gold standard. The detected rates of HRHPV E6/E7 mRNA and HR-HPV DNA were compared among different groups. The statistical analysis was performed with χ^2test or Fisher＇s exact test, the used software was SPSS16.0. Results The positive rates of HR-HPV E6/E7 mRNA and HR-HPV DNA in CIN Ⅰ, CIN Ⅱ and CIN Ⅲ groups were 52.38% and 64.29%, 84.85% and 87.88% or 93.33% and 93.33%, respectively; the positive rates of HR-HPV E6/E7 mRNA and HR-HPV DNA in SCC group were 100.00% and 100.00%, which were significantly higher than those（14.75% and 34.97%）in inflammation group（P〈0.05）. The positive rates of CINⅡ, CINⅢ and SCC groups were significantly higher than those in CINⅠ group（P〈0.05）. In inflammation group, the positive rate of HR-HPV DNA was significantly higher than that of HR-HPV E6/E7 mRNA（P〈0.05）. The specificity and positive predictive value of HR-HPV E6/E7 mRNA were significantly higher than those of HR-HPV DNA（P〈0.01）. The sensitivity of HR-HPV E6/E7 mRNA and TCT test were 73.20% and 81.44%, but the sensitivity of HR-HPV E6/E7 mRNA combined with TCT test was 92.78%, there was significant difference（P〈0.05）. Conclusion The sensitivity and specificity of HR-HPV E6/E7 mRNA test were higher in CINⅡ, CINⅢ and SCC groups. HR-HPV E6/E7 mRNA test combined with TCT test could enhance the detection rate of cervical lesions.

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

分 类 号：R373.3[医药卫生—病原生物学]