宫颈脱落细胞miR-125b与宫颈病变关系及其在HR-HPV阳性患者分层筛查中的作用研究  

The Relationship between Cervical Exfoliated Cell miR-125b and Cervical Lesions and its Role in Stratified Screening of HR-HPV Positive Patients

作　　者：NEELAM SAH 聂小凤[1] 张琴[1] 张素仙[1] 杨丽华[1] NEELAM SAH;NIE Xiao-feng;ZHANG Qin;ZHANG Su-xian;YANG Li-hua(Department of Gynecology,the 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23期76-78,82,共4页Journal of Medical Information

基　　金：国家自然科学基金地区项目(编号:81360336);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)

摘　　要：目的比较正常宫颈、宫颈上皮内瘤变及宫颈癌患者宫颈脱落细胞中miR-125b表达水平差异,探讨宫颈脱落细胞miR-125b表达水平检测在HR-HPV阳性患者分层筛查中的作用及其与宫颈病变的关系。方法采用第二代杂交捕获技术进行HR-HPV初筛,HR-HPV阳性患者行宫颈液基薄层细胞学检查及miR-125b检测。液基细胞学检查结果异常者直接阴道镜下活检行病理学检查,液基细胞学检查正常者行阴道镜检查,阴道镜检查下发现异常者行阴道镜下活检取材,余视作宫颈组织学正常,不做宫颈活检。RT-qPCR检测正常宫颈及不同级别宫颈病变中miR-125b表达水平,比较不同组织学分组之间的宫颈脱落细胞miR-125b表达水平,绘制ROC曲线,探讨miR-125b、液基细胞学检查在宫颈病变中的诊断作用。结果宫颈脱落细胞miR-125b水平随着宫颈病变程度加重逐渐升高(P<0.05);在HR-HPV阳性患者分层筛查中,宫颈液基细胞学诊断宫颈高级别上皮内病变的敏感性、特异性分别为64.90%、80.70%,AUC为0.728(95%CI:0.657～0.779,P<0.001)。与液基细胞学检查相比,宫颈脱落细胞miR-125b检测诊断宫颈高级别上皮内病变的灵敏性、特异性更高(87.30%vs 64.90%;69.20%vs80.70%),AUC为0.864(95%CI:0.800～0.928,P<0.001)。结论 miR-125b水平随着宫颈病变加重逐渐升高,检测宫颈脱落细胞miR-125b水平可有效分流HR-HPV阳性患者,敏感性高于细胞学检查,可能成为一种有效的分层筛查方法。Objective To compare the expression levels of miR-125b in cervical exfoliated cells of normal cervix,cervical intraepithelial neoplasia and cervical cancer,and to explore the role of miR-125b expression in cervical exfoliated cells in stratified screening of HR-HPV positive patients.The relationship between cervical lesions.Methods The second-generation hybridization capture technique was used for HR-HPV screening.The HR-HPV-positive patients underwent cervical-based thin-layer cytology and miRNA125b detection.The results of liquid-based cytology were abnormal.The pathological examination was performed directly under biopsy.The liquid-based cytology was performed by colposcopy.The abnormalities were found under colposcopy.The colposcopy biopsy was performed.Normal,no cervical biopsy.RT-qPCR was used to detect the expression of miR-125b in normal cervical and different grades of cervical lesions.The expression levels of miR-125b in cervical exfoliated cells were compared between different histological groups.ROC curves were drawn to investigate miR-125b and liquid-based cytology.The role of diagnosis in cervical lesions.Results The level of miR-125b in cervical exfoliated cells increased with the severity of cervical lesions(P<0.05).In the stratified screening of HR-HPV positive patients,the sensitivity of cervical liquid-based cytology in the diagnosis of high-grade intraepithelial lesions of the cervix,The specificities were64.90%and80.70%,respectively,and the AUC was0.728(95%CI:0.657~0.779,P<0.001).Compared with liquid-based cytology,the sensitivity and specificity of cervical exfoliated cells miR-125b for the diagnosis of high-grade intraepithelial lesions of the cervix were higher(87.30%vs64.90%;69.20%vs80.70%),and the AUC was0.864(95%CI:0.800~0.928,P<0.001).Conclusion The level of miR-125b is gradually increased with the increase of cervical lesions.The detection of miR-125b in cervical exfoliated cells can effectively divert HR-HPV positive patients,which is more sensitive than cytology and may be an effect

关 键 词：宫颈病变 miR-125b HR-HPV 宫颈癌筛查 

分 类 号：R[医药卫生]