HPV E6/E7 mRNA与HPV E6/E7 DNA在筛查宫颈鳞状上皮内病变中的应用价值  

Application value of HPV E6/E7 mRNA and HPV E6/E7 DNA in screening cervical squamous intraepithelial lesions

作　　者：田莉[1] 陈文[2] 骆元斌[1] 黄小玲[1] TIAN Li;CHEN Wen;LUO Yuan-bin;HUANG Xiao-ling(Department of Pathology,2Department of Foot and Ankle Surgery,Gansu Provincial Hospital of Traditional Chinese Medicine,Lanzhou 730050,China)

机构地区：[1]甘肃省中医院病理科,甘肃兰州730050 [2]甘肃省中医院足踝骨科,甘肃兰州730050

出　　处：《中国病理生理杂志》2020年第12期2300-2304,共5页Chinese Journal of Pathophysiology

摘　　要：目的:通过回顾性统计分析比较人乳头瘤病毒(HPV)E6/E7 mRNA和DNA两种检测方法,探讨两者在筛查宫颈鳞状上皮内病变中的作用。方法:选取2018年10月~2019年10月于甘肃省中医院病理科行液基薄层细胞学检查的206例患者,进行HPV E6/E7 mRNA检测、HPV E6/E7 DNA检测及p16免疫组化染色,观察不同细胞学和组织学分级的检测结果。结果:不同细胞学分级,HPV E6/E7 mRNA和DNA的阳性率随宫颈鳞状上皮内病变的进展呈递增趋势(P<0.05),意义不明确的非典型鳞状上皮细胞(ASC-US)中HPV E6/E7 mRNA的检出率低于HPV E6/E7 DNA(P<0.05)。不同组织病理学分级,HPV E6/E7 mRNA和DNA的阳性率随宫颈鳞状上皮内病变的进展呈递增趋势(P<0.05),低级别鳞状上皮内病变(LSIL)中HPV E6/E7 mRNA的检出率低于HPV E6/E7 DNA(P<0.05)。p16免疫组化染色阳性率随宫颈鳞状上皮内病变级别的升高呈递增趋势(P<0.05)。HPV E6/E7 DNA+p16联合筛查宫颈鳞状上皮内病变灵敏度最高,HPV E6/E7 mRNA的特异度最高;在LSIL中,HPV E6/E7 DNA的阳性预测值最高,在高级别鳞状上皮内病变(HSIL)中HPV E6/E7 mRNA+p16的阳性预测值最高。结论:在筛查宫颈鳞状上皮内病变时,HPV E6/E7 DNA检测加p16免疫组化染色的灵敏度最高;HPV E6/E7 mRNA能更准确地反映HPV的活化状态;在HSIL筛查中,HPV E6/E7 mRNA加p16免疫组化染色则更具有特异性。AIM:To investigate the diagnostic value of human papillomavirus(HPV)E6/E7 mRNA and DNA detection in cervical squamous epithelial lesion screening via retrospective analysis.METHODS:The HPV E6/E7 mRNA detection,HPV E6/E7 DNA detection and p16 immunohistochemistry were performed in 206 patients undergoing ThinPrep cytology test(TCT)in Gansu Provincial Hospital of Traditional Chinese Medicine,and the results of different cytological and histological grades were observed.RESULTS:The positive rates of HPV E6/E7 mRNA and DNA were increased with the progress of cervical squamous intraepithelial lesions(P<0.05)in different cytological grades and histopathological grades.The detection rate of HPV E6/E7 mRNA was lower than that of HPV E6/E7 DNA(P<0.05)in atypical squamous cells of undetermined significance(ASC-US)and low-grade squamous intraepithelial lesion(LSIL).The results of immunohistochemistry showed that the positive rate of p16 was increased with the grade of cervical squamous epithelial lesions(P<0.05).HPV E6/E7 DNA+p16 for cervical squamous epithelial lesion screening had the highest sensitivity,and the specificity of HPV E6/E7 mRNA was the highest.The positive predictive value of HPV E6/E7 DNA was the highest in LSIL,while the positive predictive value of HPV E6/E7 mRNA+p16 was the highest in high-grade squamous intraepithelial lesion(HSIL).CONCLUSION:HPV E6/E7 DNA+p16 has the highest sensitivity in screening for cervical squamous epithelial lesions.HPV E6/E7 mRNA more accurately reflects the activation status of HPV,especially in HSIL screening,HPV E6/E7 mRNA+p16 is more specific.The results of this research provide stronger theoretical support forclinical treatment.

关 键 词：人乳头瘤病毒 宫颈鳞状上皮内病变 P16蛋白 

分 类 号：R737.33[医药卫生—肿瘤] R33-33[医药卫生—临床医学]