液基薄层细胞学检测、高危型人乳头状瘤病毒-DNA和人乳头状瘤病毒E6/E7 mRNA检测在宫颈癌早期筛查中的临床价值  

Clinical value of TCT,high-risk HPV-DNA and HPV E6/E7 mRNA detection in early screening of cervical cancer

作　　者：单继烈 叶素梅 王兰英 高国生[4] SHAN Ji - lie , YE Su - mei, WANG Lan - ying, GAO Guo - sheng(Blood Transfusion Section, Fenghua District People＇s Hospital of Ningbo, Ningbo, Zhejiang 315500, Chin)

机构地区：[1]宁波市奉化区人民医院输血科,浙江宁波315500 [2]宁波市奉化区江口街道卫生院,浙江宁波315500 [3]宁波市余姚人民医院妇产科,浙江宁波315420 [4]宁波市第二医院检验科,浙江宁波315010

出　　处：《中国卫生检验杂志》2018年第6期667-669,672,共4页Chinese Journal of Health Laboratory Technology

基　　金：宁波市领军和拔尖人才(20150012)

摘　　要：目的探讨液基薄层细胞学检测(TCT)、高危型HPV-DNA和HPV E6/E7 mRNA检测在宫颈癌早期筛查中的临床价值。方法选择2014年1月-2016年5月在本院妇科就诊的女性患者220例,均经阴道镜下活检和组织病理学检查。收集宫颈脱落细胞进行液基薄层细胞学检测(TCT),同时利用荧光PCR法和化学发光法检测患者标本中的高危亚型HPV DNA和HPV E6/E7 mRNA,对检测结果进行统计学分析。结果 TCT结果和组织病理学存在较好的一致性(线性和线性组合值=61.28,P<0.01)。TCT、高危型HPV-DNA和HPV E6/E7 mRNA检测诊断宫颈上皮内瘤变(CIN)Ⅱ+级患者的敏感度分别为51.32%、92.11%、86.84%,特异度分别为93.06%、11.11%、31.25%。TCT和HPV E6/E7 mRNA联合检测的敏感度达到90.79%,特异度为100.00%。结论 TCT联合HPV E6/E7 mRNA检测可以有效提高对高级别宫颈病变的诊断效能。Objective To investigate the clinical value of liquid-based thin-layer cytology test（ TCT）,high-risk HPV-DNA and HPV E6/E7 mRNA detection in the early screening of cervical cancer. Methods From 2014 January to 2016 May,220 female patients underwent colposcopy biopsy and histopathological examination. Cervical exfoliated cells were collected for liquid-based thin-layer cytology,and the fluorescence PCR and chemiluminescence were used to detect the expressions of high-risk HPV DNA and HPV E6/E7 mRNA in the specimens of the patients. The results were analyzed statistically.Results There was a good linearity between TCT results and histopathology（ linear-by-linear association value was 61. 28,P 0. 01）. The sensitivity of TCT,HPV-DNA and HPV E6/E7 mRNA detection in the diagnosis of cervical intraepithelial neoplasia（ CIN） Ⅱ ＋ patients was 51. 32%,92. 11% and 86. 84%,respectively,and the specificity was 93. 06%,11. 11%and 31. 25%,respectively. The sensitivity and specificity of TCT and HPV E6/E7 mRNA combined detection were 90. 79%and 100. 00%. Conclusion Combined detection of TCT with HPV E6/E7 mRNA can effectively improve the diagnostic effectiveness of high-grade cervical lesions.

关 键 词：人乳头状瘤病毒 液基薄层细胞学 E6/E7 mRNA 宫颈上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]