HPV E6/E7 mRNA检测对宫颈上皮内瘤变患者的预后价值  

Prognostic value of HPV E6/E7 mRNA detection in patients with cervical intraepithelial neoplasia

作　　者：桂定清 张力忆[1] 青友芬 王琳[1] 戚瑞虹 李静蓉 刘芳[1] GUI Dingqing;ZHANG Liyi;QING Youfen;WANG Lin;QI Ruihong;LI Jingrong;LIU Fang(Department of Obstetrics and Gynecology,Dazhou Central Hospital, Dazhou Sichuan 635000, China)

机构地区：[1]达州市中心医院妇产科,四川达州635000

出　　处：《空军医学杂志》2018年第6期408-411,共4页Medical Journal of Air Force

基　　金：四川省达州市卫生与计划生育委员会课题(150055)

摘　　要：目的探讨HPV E6/E7 mRNA检测对宫颈上皮内瘤变患者的预后价值。方法选取2012—2015年于达州市中心医院行宫颈锥切术治疗的112例宫颈上皮内瘤变(cervical intraepit helial neoplasia,CIN)患者作为研究对象,采用回顾性分析法分析所有患者的临床及随访资料,根据其资料结果可知所有患者在随访期间均进行了薄层液基细胞学检查(thin-prep cytologytest,TCT)、HPV-DNA检测、HPVE6/E7mRNA检测,且对于上述检测疑似阳性检测者均行病理学检查,且依据病理学检查结果记录患者的复发情况,并分析不同检测方法在不同病情患者中阳性率的差异。结果 112例行宫颈锥切术治疗的CIN患者复发20例,复发率为17.86%,病灶残留/复发共30例,病灶残留/复发的发生率为26.79%;TCT检测其阳性率在术后12个月时最高,而在术后24个月时最低;HR-HPV DNA检测阳性率在术后3个月时最高,术后18个月时最低,而HPV E6/E7mRNA检测法检出阳性率在术后3个月最高,其后在术后各随访时间点均逐渐下降;至随访结束,所有复发患者中,3例TCT出现异常,10例HR-HPV DNA为阳性,2例HPV E6/E7 mRNA检测为阳性(P<0.05);TCT、HR-HPV DNA和HPV E6/E7mRNA检测预测CIN术后复发/残留病灶的灵敏度分别为84.60%、92.62%和78.46%,但HPV E6/E7 mRNA检测预测CIN术后复发/残留病灶的特异性(89.60%)高于TCT(70.64%)和HR-HPV DNA(72.64%)(P<0.05)。结论 HR-HPV DNA检测预测CIN患者术后复发/残留病灶具有较高的敏感性,但HPV E6/E7 mRNA的检测对于预测CIN患者术后复发/残留病灶的特异性更佳,更具有临床价值,故可将其纳入评估CIN患者术后预后的有效检测方法。Objective To investigate the prognostic value of HPV E6/E7 mRNA detection in patients with cervical intraepithelial neoplasia.Methods A total of 112 CIN patients undergoing cervical conization in Dazhou Central Hospital between 2012 and 2015 were selected as the subjects.The clinical and follow-up data of all these patients was analyzed retrospectively.According to the Results of the data,these patients underwent a thin-prep cytology test(TCT),HR-HPV DNA test and HPV E6/E7 mRNA test during the follow-up.Suspected positive cases were subjected to pathological examination.Based on the Results of the pathological examination,the recurrence of the disease was recorded and the difference in the positive rates of different test Methods between patients of different diseases were analyzed.Results Among the 112 CIN patients who underwent conization of the cervix,20 cases relapsed,so the recurrence rate was 17.86%.Thirty cases had residual or recurrent lesions,accounting for 26.79%.The positive rate of TCT detection reached the highest at 12 months after surgery,but dropped to the lowest at 24 months after surgery.The positive rate of HR-HPV DNA test was the highest at 3 months after operation and the lowest at 18 months after operation.The positive rate of HPV E6/E7 mRNA was the highest at 3 months after operation.At the end of follow-up,TCT was abnormal in 3 of the relapses,10 cases of HR-HPV DNA were positive,and 2 cases of HPV E6/E7 m RNA were positive(P<0.05).The sensitivities of detection of TCT,HR-HPV DNA and HPV E6/E7 mRNA in predicting CIN recurrence/residual lesions were 84.60%,92.62%and 78.46%,respectively.However,the specificity of HPV E6/E7 mRNA in predicting relapses and residual lesions(89.60%)was significantly higher than that of TCT(70.64%)and HR-HPV DNA(72.64%)(P<0.05).Conclusion HR-HPV DNA is highly sensitive to the detection of postoperative recurrence/residual lesions in patients with CIN.However,the detection of HPV E6/E7 mRNA is more specific for the prediction of postoperative recurrence/residual l

关 键 词：HPV E6/E7 MRNA检测 宫颈上皮内瘤变 宫颈锥切术 预后 预测价值 

分 类 号：R711[医药卫生—妇产科学]