人乳头瘤病毒E6/E7 mRNA检测在宫颈癌筛查中的应用价值  

Application value of human papilloma virus E6/E7 mRNA detection in cervical cancer screening

作　　者：刘冬梅[1] 张宁[1] 范俊丽[2] LIU Dongmei;ZHANG Ning;FAN Junli(Department of Clinical Laboratory,Nanyang Second General Hospital,Nanyang 473000,He’nan,China;Prenatal Diagnosis Center,Nanyang Second General Hospital,Nanyang 473000,He’nan,China)

机构地区：[1]南阳市第二人民医院检验科,河南南阳4730000 [2]南阳市第二人民医院产前诊断中心,河南南阳4730000

出　　处：《癌症进展》2022年第6期619-623,共5页Oncology Progress

摘　　要：目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA检测在宫颈癌筛查中的应用价值。方法选取液基薄层细胞学检查(TCT)阳性的350例HPV感染患者,均接受HPV DNA检测和HPV E6/E7 mRNA检测,比较不同TBS分级、不同年龄段、不同病变程度HPV E6/E7 mRNA及HPV DNA的检出情况。以阴道镜病理活检为金标准,比较HPV E6/E7 mRNA与HPV DNA检测对宫颈癌的诊断效能。结果350例受检者中,HPV E6/E7 mRNA阳性检出率为77.71%,与HPV DNA的76.57%比较,差异无统计学意义(P﹥0.05)。不同TBS分级受检者HPV E6/E7 mRNA、HPV DNA的阳性检出率比较,差异均有统计学意义(P﹤0.01)。HPV E6/E7 mRNA检测对31~40岁、41~50岁、≥51岁患者的阳性检出率均高于HPV DNA检测(P﹤0.05)。随着宫颈病变程度的升高,HPV E6/E7 mRNA阳性检出率逐渐升高(P﹤0.01)。以阴道镜病理活检为金标准,350例受检者中,宫颈癌47例,宫颈病变303例。HPV E6/E7 mRNA检测诊断宫颈癌的灵敏度为95.74%,特异度为25.08%,阳性预测值为16.54%;HPV DNA检测诊断宫颈癌的灵敏度为87.23%,特异度为25.08%,阳性预测值为15.30%;HPV E6/E7 mRNA检测诊断宫颈癌的灵敏度高于HPV DNA检测。结论HPV E6/E7 mRNA检测可作为宫颈癌及癌前病变的重要筛查方法,对不同年龄段女性宫颈病变的筛查也有重要意义。Objective To explore the application value of human papilloma virus(HPV)E6/E7 mRNA detection in cervical cancer screening.Method A total of 350 HPV-infected patients with positive thin-prep cytology test(TCT)were selected,and all received HPV DNA detection and HPV E6/E7 mRNA detection.To compare the detection of HPV E6/E7 mRNA and HPV DNA in different TBS grades,different age groups,and different lesion degrees.Using colposcopy biopsy as the gold standard,the diagnostic efficacy of HPV E6/E7 mRNA and HPV DNA detection in cervical cancer were compared.Result Among the 350 subjects,the positive detection rate of HPV E6/E7 mRNA was 77.71%,which was not statistically significant compared with 76.57%of HPV DNA(P>0.05).Subjects with different TBS grade,the positive detection rates of HPV E6/E7 mRNA and HPV DNA were significantly different(P<0.01).The positive detection rate of HPV E6/E7 mRNA detection in patients aged 31-40 years,41-50 years and≥51 years were higher than that of HPV DNA detection(P<0.05).With the increase of cervical lesions,the positive detection rate of HPV E6/E7 mRNA gradually increased(P<0.01).Taking colposcopy biopsy as the gold standard,among the 350 subjects,47 were cervical cancer and 303 were cervical lesions.The sensitivity of HPV E6/E7 mRNA detection in the diagnosis of cervical cancer was 95.74%,the specificity was 25.08%,and the positive predictive value was 16.54%.The sensitivity of HPV DNA detection in the diagnosis of cervical cancer was 87.23%,the specificity was 25.08%,and the positive predictive value was 15.30%.The sensitivity of HPV E6/E7 mRNA detection in the diagnosis of cervical cancer was higher than that of HPV DNA detection.Conclusion HPV E6/E7 mRNA detection can be used as an important screening method for cervical cancer and precancerous lesions,and it is also of great significance for the screening of cervical lesions in women of different ages.

关 键 词：宫颈癌 人乳头瘤病毒 液基薄层细胞学检查 

分 类 号：R737.33[医药卫生—肿瘤]