高危型HPV E6/E7 RNA原位杂交检测在宫颈鳞状上皮癌前病变中的诊断价值  

Diagnostic value of HPV E6/E7 mRNA in situ hybridization signal in cervical squamous epithelial precancerous lesions

作　　者：马亚琪[1] 刘鹏[1] 宋欣[1] 王利群[1] 刘爱军[1] MA Ya-qi;LIU Peng;SONG Xin;WANG Li-qun;LIU Ai-jun(Department of Pathology,the First Medical Center,the General Hospital of PLA,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心病理科,北京100853

出　　处：《诊断病理学杂志》2020年第9期637-642,共6页Chinese Journal of Diagnostic Pathology

基　　金：解放军总医院临床科研扶持基金《宫颈癌相关分子检测及临床应用研究》(2015FC-TSYS-1025)。

摘　　要：目的①应用新型RNA scope技术检测高危型HPV E6/E7 mRNA在宫颈鳞状上皮内病变组织中的表达,探讨RNA原位杂交技术在宫颈病变中的意义。②分析高危型HPV E6/E7 mRNA原位杂交检测与HPV DNA分型检测在宫颈鳞状上皮癌前病变中的一致性,及其在宫颈鳞状上皮癌前病变诊断中的价值。方法收集宫颈活检或锥形切除的宫颈组织258例,其中包含病理诊断为高级别和低级别鳞状宫颈鳞状上皮内病变(SIL)/宫颈鳞状上皮内病变(CINⅠ~CINⅢ病例),并选取同期宫颈活检诊断为炎症的病例作为对照组。对所有收集病例进行HR HPV E6/E7 mRNA原位杂交检测,同时查阅入组病例临床HPV DNA检查结果并进行分析。结果①258例样本中,HR HPV E6/E7 mRNA原位杂交总体阳性率为79.5%(205/258);在各组中阳性率为:炎症组45.5%(15/33),LSIL70.9%(78/110),HSIL97.4%(112/115);各组间差异显著(χ~2=50.960,P<0.0001)。②经kappa检验可知,HR HPV E6/E7 mRNA原位杂交与HPV DNA检测在HSIL中一致性较高(kappa=0.796)。结论①HR HPV E6/E7 mRNA原位杂交阳性率随着宫颈病变级别升高而增高,证实HR HPV E6/E7 mRNA的结果对诊断和区分宫颈病变程度具有价值,可以为宫颈鳞状上皮癌前病变的分流提供更多证据。②HR HPV E6/E7 mRNA原位杂交与HPV DNA检测在HSIL中一致性最高,HPV DNA检测对炎症和LSIL的敏感性高,HR HPV E6/E7 mRNA原位杂交检测对LSIL和HSIL的特异性更好。Objective To detect the expression of high-risk HPV E6/E7 mRNA in cervical intraepithelial neoplasia and cervical cancer tissues by a novel RNA scope technology and to explore the diagnostic value of RNA in situ hybridization in cervical lesions,and to analyze the consistency of high-risk HPV E6/E7 mRNA in situ hybridization detection and HPV DNA typing detection in cervical squamous epithelial precancerous lesions and its value in the diagnosis of cervical squamous epithelial precancerous lesions. Methods A total of 258 cases of cervical tissue from cervical biopsy or conical resection of the Department of Pathology of the General Hospital of PLA from January 2016 to December 2017 were collected,including high-grade and low-grade squamous squamous intraepithelial lesions(SIL)/cervical squamous intraepithelial lesions(CINⅠ,CINⅡ,CINⅢ and CINⅡ-Ⅲ cases),and cases with inflammation diagnosed by cervical biopsy at the same time were selected as the control group. The HPV DNA test and the clinical examination data of the enrolled patients were reviewed. Results In the 258 samples,the overall positive rate of HR HPV E6/E7 mRNA in situ hybridization was 79. 46%(205/258);the expression in each group was 45. 45%(15/33) in the inflammation group,70. 91%(78/110) in LSIL group and 97. 39%(112/115) in HSIL group;there was a statistically significant difference between the groups(χ~2= 50. 960 P<0. 001). Consistency of HR HPV E6/E7 mRNA in situ hybridization and HPV DNA detection showed that HR HPV E6/E7 mRNA in situ hybridization and HPV DNA had higher consistency in the detection of HSIL by Kappa test(kappa = 0. 796). Conclusion The positive rate of HR-HPV E6/E7 mRNA in situ hybridization increases as the level of cervical lesions rises. It is confirmed that the results of HR-HPV E6/E7 mRNA are valuable for diagnosis and differentiatial diagnosis of cervical lesions and can provide more evidence for the diversion of cervical squamous epithelial precancerous lesions. HR-HPV E6/E7 mRNA in situ hybridization and HPV DN

关 键 词：HR HPV E6/E7 mRNA原位杂交 宫颈鳞状上皮内病变 SIL 

分 类 号：R737.33[医药卫生—肿瘤]