孕产妇宫颈病变筛查中高危HPVE6/E7mRNA与HPV DNA检测的临床价值  

Clinical value of E6/E7 mRNA detection of high risk HPV for screening cervical lesions of pregnant women and puerpera

作　　者：欧凤柳 胡艳丽 秦永 OU Fengliu;HU Yanli;QIN Yong(Qianjiang Central Hospital of Chongqing,Chongqing,409000)

机构地区：[1]重庆市黔江中心医院,409000

出　　处：《中国计划生育学杂志》2020年第7期1060-1063,共4页Chinese Journal of Family Planning

摘　　要：目的:研究高危HPVE6/E7mRNA检测与HPV DNA检测在孕产妇宫颈病变筛查中的临床价值。方法:选择2018年6月—2019年6月在本院接受治疗的伴有宫颈病的孕产妇64例,以宫颈病理结果为依据,对不同级别宫颈病变中者分别进行HPV E6/E7 mRNA和HPV DNA检测,比较两种检测方法效能。结果:检出慢性炎症、CINⅠ、CINⅡ、CINⅢ以及宫颈癌的阳性率,HPVE6/E7mRNA检测与HPV DNA检测无差异,总阳性率HPVE6/E7mRNA检测(53.1%)与HPV DNA检测(59.4%)无差异(均P>0.05)。两种检测的一致性慢性炎症与CIN分别为80.8%和85.2%,宫颈癌为81.8%,其κ值分别为0.42、0.56、0.81。两种检测的特异性HPV DNA(60.2%)低于HPVE6/E7mRNA(85.2%)(P<0.05),敏感性、阳性预测值及阴性预测值无差异(P>0.05)。结论:相比HPV NDA检测,HPVE6/E7mRNA检测能更好预测孕产妇宫颈病变进展,特别是针对高级别宫颈病变的特异性更强。Objective:To study the clinical value of E6/E7 mRNA detection of high risk HPV for screening cervical lesions of pregnant women and puerpera. Methods: 64 patients with cervical disease were selected as research objects from June 2018 to June 2019. Based on their results of the cervical pathology, the E6/E7 mRNA of HPV detection and HPV DNA detection were performed for patients with different grades of cervical lesions, and the detection efficiency were compared between the two detections. Results: The positive rate of E6/E7 mRNA of HPV detection of patients with chronic inflammation, CIN Ⅰ, CIN Ⅱ, CIN Ⅲ had no significant different from that of HPV DNA detection. The total positive rate of E6/E7 mRNA of HPV detection was 53.1%, which had no significant different from that(59.4%) of HPV DNA detection(all P>0.05). The detection consistency by the two detections for patients with chronic inflammation, CIN, and cervical cancer were 80.8%, 85.2%, and 81.8%, respectively, and their κvalues were 0.42, 0.56 and 0.81, respectively. The specificity by HPV DNA detection was 60.2%, which was significant lower than that(85.2%) by E6/E7 mRNA of HPV detection(P<0.05). There were no significant different in the sensitivity, the positive predictive value, and the negative predictive value between HPV DNA detection and E6/E7 m RNA of HPV detection(P>0.05). Conclusion: Compared with HPV NDA detection, E6/E7 mRNA of HPV detection can better predict the progress of cervical lesions of pregnant women and puerpera, especially for women with high-grade cervical lesions.

关 键 词：孕产妇 宫颈病变 人乳头瘤病毒 HPV E6/E7 mRNA HPV DNA 

分 类 号：R737.33[医药卫生—肿瘤]