Aptima HPV E6/E7 mRNA 16,18/45基因型检测技术在宫颈癌前病变和宫颈癌筛查中的应用价值  

Clinical application of Aptima HPV E6/E7mRNA 16 and 18/45 technology in cervical cancer and precancerous lesions

作　　者：吴秋珍 毛瑛玉 林茂华 李婷 郑原印 WU Qiu-zhen;MAO Ying-yu;LIN Mao-hua;LI Ting;ZHENG Yuan-yin(Department of Pathology,Mindong Hospital of Fujian Medical University,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院病理科,福建福安355000

出　　处：《诊断病理学杂志》2021年第3期202-206,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA 16,18/48基因型检测在宫颈癌筛查中的应用价值。方法收集福建省宁德市闽东医院2015—2019年间Aptima HPV E6/E7 mRNA定性检测阳性患者871例,进行Aptima HPV E6/E7 mRNA 16、18/45基因型检测,追踪其宫颈液基细胞学结果(TCT)及阴道镜活检病理结果,以病理组织学结果为"金标准",比较TCT和Aptima HPV两种检测方法对宫颈高级别病变(HSIL)及宫颈癌的风险预测能力。结果16/18/45+组发生≥HSIL的RR值是其余11型HPV+的1.490倍(95%CI为1.252~1.772),是TCT+组的1.332倍(95%CI为1.152~1.541),但低于TCT+联合16/18/45+组,差异均有统计学意义(P<0.05)。结论单独TCT检查存在一定的漏诊率,需联合HPV检测以提高诊断的敏感性;HPV E6/E7 mRNA检测尤其是16/18/45分型检测对≥HSIL的风险预测能力优于TCT检测;HPV E6/E7 mRNA联合TCT检查对降低≥HSIL的漏诊率具有重要临床意义。Objective To explore the application value of human papillomavirus(HPV)E6/E7 mRNA 16,18/48 genotype detection in cervical cancer screening.Methods A total of 871 patients with positive Aptima HPV E6/E7 mRNA qualitative detection from 2015 to 2019 in Mindong Hospital of Ningde City,Fujian Province were collected.Aptima HPV E6/E7 mRNA 16 and 18/45 genotypes were tested and their cervical liquid-based cytology and colposcopy biopsy.With histopathological results as the"gold standard",the two detection methods TCT and Aptima HPV were compared in the risk prediction ability of cervical high-grade lesions(HSIL)and cervical cancer.Results The RR value of≥HSIL in the 16/18/45+group was 1.490 times(95%CI:1.252~1.772)of the other 11 types of HPV+and 1.332 times(95%CI:1.152~1.541)of the TCT+group,but it was low in the TCT+combined 16/18/45+group,the differences were statistically significant(P<0.05).Conclusion TCT alone has a certain missed diagnosis rate,and HPV testing needs to be combined to improve the sensitivity of diagnosis;HPV E6/E7 mRNA detection,especially 16/18/45 typing detection,has better risk prediction ability for≥HSIL than TCT detection;HPV E6/E7 mRNA combined with TCT examination has important clinical significance in reducing the missed diagnosis rate of HSIL.

关 键 词：宫颈癌筛查 宫颈液基细胞学(TCT) HPV16 HPV18/45 宫颈上皮内瘤变(CIN) 

分 类 号：R737.3[医药卫生—肿瘤]