HPV E6/E7 mRNA与HPV-23分型检测用于宫颈脱落细胞学阳性女性的临床价值  

Clinical value of HPV E6/E7 mRNA detection and HPV-23 genotyping in young women with positive cervical exfoliation cytology

作　　者：杨文娟[1] 叶君[1] 陈炎 杨爱平[2] YANG Wenjuan;YE Jun;CHEN Yan;YANG Aiping(Department of Clinical Laboratory,Xiaoshan Hospital,Hangzhou 311202,China)

机构地区：[1]浙江萧山医院检验科,杭州311202 [2]浙江萧山医院中心实验室,杭州311202

出　　处：《浙江医学》2021年第14期1509-1512,共4页Zhejiang Medical Journal

基　　金：萧山区重大科技计划项目(2018221);萧山区科技计划项目(20180320)。

摘　　要：目的探讨人乳头状瘤病毒(HPV)E6/E7 mRNA、HPV基因分型(HPV-23分型)检测用于宫颈脱落细胞学阳性女性的临床价值。方法选择2017年1月至2018年12月浙江萧山医院宫颈薄层液基细胞学检查结果阳性的患者360例,均行经阴道镜下宫颈组织活检,统计分析标本病理学分级、TBS分类、E6/E7、HPV-23分型检测结果。采用Spearman秩相关分析TBS分类、病理学分级、E6/E7、HPV-23分型结果之间的相关性,E6/E7检测结果与TBS分类、病理学分级一致性检验采用Kappa分析。结果在宫颈细胞学TBS分类方面,非典型鳞状细胞(ASC-H)的E6/E7阳性率最高(83.33%),且E6/E7阳性率与拷贝数明显高于其它型别,差异有统计学意义(P<0.05)。TBS分类与E6/E7拷贝数、阳性率均呈正相关(r=0.700、0.855,均P<0.05);不同病理学分级中,未见上皮内细胞病变(NILM)、宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ的E6/E7阳性率依次递增,差异有统计学意义(P<0.05)。病理学分级与E6/E7阳性率呈正相关(r=0.842,P<0.05),而与HPV-23分型结果无相关性(r=0.242,P<0.05)。不同病理学分级及TBS分类患者HPV-23分型和E6/E7检测结果高度一致(Kappa=0.647、0.701,均P<0.05)。结论E6/E7拷贝数检测可作为预测宫颈病变的良好指标;E6/E7与HPV-23分型检测是女性宫颈癌筛查及宫颈疾病诊断的重要实验室指标。Objective To evaluate the application of human papillomavirus(HPV)E6/E7 mRNA detection and HPV-23 genotyping in women with positive cervical exfoliation cytology.Methods Three hundred and sixty women with positive cervical liquid based cytology were enrolled in the study from January 2017 to December 2018.The results of pathological grade,E6/E7 mRNA expression and HPV genotyping were analyzed retrospectively.The correlation among TBS grade,pathological grade,E6/E7 mRNA expression and HPV-23 genotype was analyzed by Spearman correlation analysis.Results The positive rate of E6/E7 mRNA expression in ASC-H was the highest(83.33%).Spearman correlation analysis showed that TBS grading was correlated with the positive rate of E6/E7 mRNA expression and the number of copies of E6/E7(r=0.855,0.700,all P<0.05).The pathological grade was correlated with the positive rate of E6/E7(r=0.842,P<0.05),but not with the results of HPV-23(r=0.242,P<0.05).Kappa consistency analysis showed that HPV genotype and E6/E7 were highly consistent in patients with different pathological grades and TBS grades(Kappa=0.647,0.701,P<0.05).Conclusion The positive expression rate and number of copies of E6/E7 can be used as indicators for predicting cervical lesions,which can be used for screening and detecting cervical cancer in young women with positive cervical exfoliation cytology.

关 键 词：E6/E7 宫颈脱落细胞学 人乳头状瘤病毒 基因分型 

分 类 号：R737.33[医药卫生—肿瘤]