宫颈脱落细胞miR34a检测在HR-HPV阳性患者分流中的作用分析  

Analysis of the Role of MiR34a in Cervical Exfoliated Cells in Shunt of HR-HPV Positive Patients

作　　者：聂小凤[1] 翟慧慧 冷天艳[1] 张琴[1] 杨丽华[1] NIE Xiao-feng;ZHAI Hui-hui;LENG Tian-yan;ZHANG Qin;YANG Li-hua(Department of Gynecology,Second Affiliated Hospital of Kunming Medical University,Kunming,650101,Yunnan,China)

机构地区：[1]昆明医科大学第二附属医院妇科,云南昆明650101

出　　处：《医学信息》2018年第16期43-46,共4页Journal of Medical Information

基　　金：云南省教育厅科学研究基金项目(编号:2015Z074);云南省卫生和计划生育委员会医学学科带头人培养项目(编号:D-201633);国家自然科学基金地区项目(编号:81360336)

摘　　要：目的探讨宫颈脱落细胞miR34a检测在HR-HPV阳性患者分流中的作用。方法采用第二代杂交捕获技术(HC2)进行宫颈癌初筛,HPV阳性者行TCT及miRNA检查。TCT结果异常者(≥意义不明确的非典型鳞状细胞)阴道镜下活检行病理学检查。TCT阴性者行阴道镜检查,阴道镜异常者阴道镜下活检取材,比较不同级别宫颈病变中miR34a水平,探讨miR34a、Pap在宫颈病变中的诊断作用。结果 (1)Pap对宫颈高度鳞状上皮内病变预测值的灵敏度为64.90%,特异度为80.70%,AUC为0.728(95%CI:0.657~0.779,P<0.001)。(2)miRNA34a对宫颈高度鳞状上皮内病变预测值的灵敏度为77.00%,特异度为62.30%,AUC为0.824(95%CI:0.756~0.892,P<0.001),cut off值为0.623。(3)miRNA34a对宫颈高度鳞状上皮内病变预测值的灵敏度高于Pap检测,特异度低于Pap。(4)宫颈脱落细胞miRAN34a值随着宫颈病变加重逐渐降低。结论检测宫颈脱落细胞miR34a水平可有效分流HR-HPV阳性患者,敏感性高于Pap检查。Objective To investigate the role of miR34a in cervical exfoliated cells in the shunt of HR-HPV positive patients. Methods The second generation hybridization capture technique（HC2） was used for primary screening of cervical cancer. HPV positive patients underwent TCT and mi RNA examination. Pathological examination of colposcopy biopsy was performed in patients with abnormal TCT results（≥ atypical squamous cells with unclear significance）. TCT-negative patients underwent colposcopy, colposcopy biopsy was performed, and miR34a levels were compared in different grades of cervical lesions. The diagnostic role of miR34a and Pap in cervical lesions was explored. Results（1） The sensitivity of 1 Pap to the predictive value of high squamous intraepithelial lesion was64.90%, the specificity was 80.70%, and the AUC was 0.728（95% CI： 0.657-0.779, P〈0.001）.（2） The sensitivity of miRNA34a for predicting cervical high-grade squamous intraepithelial lesion was 77.00%, specificity was 62.30%, AUC was 0.824（95% CI：0.756-0.892, P〈0.001）, and cut off value was 0.623.（3） The sensitivity of 3 miRNA34a to the predictive value of high squamous intraepithelial lesion was higher than that of Pap, and its specificity was lower than Pap.（4） The value of mi RAN34 a in cervical exfoliated cells gradually decreased with the increase of cervical lesions. Conclusion Detection of mi R34 a levels in cervical exfoliated cells can effectively divert HR-HPV-positive patients with higher sensitivity than Pap.

关 键 词：microRNA-34a 宫颈细胞学检查 HPV 宫颈癌 筛查 

分 类 号：R737.33[医药卫生—肿瘤]