高危型HPV E6/E7mRNA检测在不典型鳞状细胞患者中的分流作用  

Shunt role of high-risk HPV E6/E7mRNA detection in patients with atypical squamous cells

作　　者：黄珊珊[1] 余婷婷[1] 郭红玲[1] 徐凤娟[1] 成雁 Huang Shanshan;Yu Tingting;Guo Hongling;Xu Fengjuan;Cheng Yan(Department of Gynecology,Taicang First People's Hospital of Soochow University,Taicang 215400,China)

机构地区：[1]苏州大学附属太仓医院(太仓市第一人民医院)妇科,江苏太仓215400

出　　处：《实用妇科内分泌电子杂志》2022年第7期9-12,共4页Electronic Journal of Practical Gynecological Endocrinology

摘　　要：目的探讨高危型人乳头状瘤病毒(HR-HPV)癌基因E6/E7 DNA活动的产物(HPV E6/E7 mRNA)检测在不典型鳞状细胞(ASCUS)患者中的分流作用。方法选取宫颈液基细胞学检查(TCT)结果为ASCUS者234例,对其进行高危型HPV E6/E7 mRNA检测以及HPV-DNA检测,分析两种检测方法在ASCUS患者分流中的作用。结果234例ASCUS患者中经阴道镜下活检病理结果为宫颈炎者92例,低级别鳞状上皮内病变(LSIL)77例,高级别鳞状上皮内病变(HSIL)62例,宫颈癌3例,经高危型HPV-DNA检查显示为阳性患者174例,高危型HPVE6/E7mRNA检查显示为阳性患者145例。在随访1年后,对有完整随访资料132例患者进行分析,高危型HPV为阴性且细胞学检查显示为正常患者101例,高危型HPV为阳性或(和)细胞学检查为阳性患者后经宫颈活检最终确诊为炎症者10例,LSIL8例,HSIL 13例。高危型HPV E6/E7mRNA检查与HPV-DNA敏感性比较,差异无统计学意义(P>0.05)。但高危型HPV E6/E7mRNA检查特异性高于HPV-DNA,差异具有统计学意义(P<0.05)o随访1年时高危型HPV E6/E7mRNA检查特异性也高于HPV-DNA检查,差异具有统计学意义(χ^(2)=4.820,P<0.05)。结论在对不典型鳞状细胞患者进行诊断时,高危型HPV E6/E7 mRNA检测具有更高的监测率,而且可以预测不典型鳞状细胞患者归转。Objective To investigate the shunting effect of HPV E6/E7 mRNA,the product of high-risk human papillomavirus(HR-HPV)oncogene E6ZE7 DNA activity,in patients with atypical squamous cells(ASCUS).Methods 234 patients with ASCUS by cervical fluid-based cytology(TCT)were selected for high-risk HPV E6/E7 mRNA detection and HPV-DNA detection,and the role of the two detection methods in the shunt of ASCUS patients was analyzed.Results 234 ASCUS patients,92 had cervicitis,77 had low-grade squamous intraepithelial lesion(LSIL),62 had high-grade squamous intraepithelial lesion(HSIL),and 3 had cervical cancer.174 patients were positive by high-risk HPV-DNA examination.High risk HPV E6/E7mRNA was positive in 145 patients.After 1 year of follow-up,132 patients with complete follow-up data were analyzed.101 patients were negative for high-risk HPV and showed normal cytology,10 patients were positive for high-risk HPV or(and)positive for cytology and finally diagnosed as inflammation by cervical biopsy,8 patients were LSIL,and 13 patients were HSIL.There was no significant difference in the sensitivity between high-risk HPV E6/E7mRNA and hpv-dna(P>0.05).However,the specificity of high-risk HPV E6/E7mRNA was higher than that of hpv-dna,and the difference was statistically significant(P<0.05).The specificity of E6/E7mRNA of high-risk HPV was also higher than that of hpv-dna at 1 year follow-up(χ^(2)=4.820,P<0.05).Conclusion High-risk HPV E6/E7 mRNA detection has a higher surveillance rate in the diagnosis of atypical squamous cell patients and can predict the outcome of atypical squamous cell patients.

关 键 词：高危型HPVE6/E7 mRNA检测 HPV-DNA检测 不典型鳞状细胞 

分 类 号：R737.33[医药卫生—肿瘤]