高危型人乳头瘤病毒E6/E7基因在未明确意义的非典型鳞状上皮细胞分流中的应用效果  

Effect of High-risk Human Papillomavirus E6/E7 Gene in Atypical Squamous Cell Shunt without Definite Significance

作　　者：黄梅秀 谢芳 林艳华 陈岚岚 李微微 HUANG Meixiu;XIE Fang;LIN Yanhua;CHEN Lanlan;LI Weiwei(Department of Gynecology,Mindong Hospital Affiliated to Fujian Medical University,Fu'an 355000,China)

机构地区：[1]福建医科大学附属闽东医院妇科,福建福安355000

出　　处：《中国医药指南》2022年第27期5-8,共4页Guide of China Medicine

基　　金：福建省青年科研课题(2020QNB056)。

摘　　要：目的 对比Aptima HPV检测(是基于HPV E6、E7 mRNA检测的方法)及Aptima HPV 16型和HPV 18型和(或)45型(18/45型)分型(Aptima HPV-GT)检测作为意义不明的非典型磷状细胞(ASCUS)分流的临床效能。方法 研究对象来源于2019年6月至2021年6月在福建医科大学附属闽东医院妇科门诊就诊,细胞学结果为ASCUS的有性生活史女性397例,选取其中有完整阴道镜召回信息及AHPV检测结果阳性的女性作为研究对象,共239例。根据ASCCP指南对其进行阴道镜检查,病变处取活检行组织病理学诊断。将病理学诊断作为金标准,分析经Aptima HPV mRNA检测的ASCUS细胞学检查和hrHPV阳性结果的患者的数据,以及他们的随访活检结果。结果 239例细胞学为ASCUS和hrHPV阳性的研究对象的年龄为(47.51±12.39)岁,其中71.55%(171例)患者在6个月内立即进行了组织学随访。在Aptima hrHPV分型检测的辅助下,ASCUS/HPV阳性患者中,HPV16阳性率为13.56%(32/236),且CIN2+(宫颈上皮内瘤变2级及以上)检出率为39.29%(11/28)。HPV 18/45阳性率8.47%(20/236),CIN2+检出率为35.29%(6/17)。HPV16、18/45阳性率为1.27%(3/236),CIN2+检出率为100.00%(2/2),失访1例,ASCUS/AHPV-GT阳性CIN2+检出率明显高于ASCUS/AHPV-GT阴性(χ^(2)=4.185,P=0.0408),ASCUS/AHPV-GT阳性CIN3+检出率明显高于ASCUS/AHPV-GT阴性(χ^(2)=5.517,P=0.0188)。结论 ASCUS患者进行HPV16、18/45分型是有意义的,建议采用HPV E6/E7 mRNA检测对ASCUS人群分流同时进行AHPV-GT检测且HPV16、18/45均阳性,可考虑快速治疗。Objective To compare the clinical efficacy of aptima HPV detection(based on HPV E6 and E7 mRNA detection) and aptima HPV 16 and HPV 18 and/or 45(18/45) typing(Aptima HPV-GT) as ascus shunt. Methods The subjects of the study were 397 women with a history of sexual life in ASCUS from June 2019 to June, 2021 in the gynecological clinic of Mindong Hospital Affiliated to Fujian Medical University. 239 women with complete colposcopy recall information and positive AHPV test results were selected as the subjects of the study. Colposcopy was performed according to ASCCP guidelines, and biopsy was taken at the lesion for histopathological diagnosis. Taking pathological diagnosis as the gold standard,the data of patients with ASCUS cytology and hrHPV positive results detected by Aptima HPV mRNA were analyzed, as well as their follow-up biopsy results. Results The age of 239 subjects with ASCUS and hrHPV positive cytology was(47.51±12.39) years old, of which 71.55%(171) patients were immediately followed up histologically within 6 months. The assistance of Aptima hrHPV typing, the positive rate of HPV16 in ASCUS/HPV positive patients was 13.56%(32/236), and the detection rate of CIN2+(cervical intraepithelial neoplasia grade 2 and above) was 39.29%(11/28). The positive rate of HPV 18/45 was 8.47%(20/236), and the detection rate of CIN2+ was 35.29%(6/17). The positive rate of HPV16 and 18/45 was 1.27%(3/236), the positive rate of CIN2+ was 100.00%(2/2), and one case was lost to follow-up. The detection rate of ASCUS/AHPV-GT positve CIN2+was significantly higher than that of ASCUS/AHPV-GT negative(χ^(2)=4.185, P=0.0408). The detection rate of ASCUS/AHPV-GT positve CIN3+ was significantly higher than that of ASCUS/AHPV-GT negative(χ^(2)=5.517, P=0.0188). Conclusion It was significant for ascus patients to classify HPV16and 18/45, it is suggested to use HPV E6/E7 mRNA detection for ascus population diversion and AHPV-GT detection at the same time, and HPV16 and 18/45 are positive, so rapid treatment can be considered.

关 键 词：宫颈上皮内瘤变 人乳头状瘤病毒(HPV) E6、E7信使RNA 意义不明的不典型鳞状细胞 

分 类 号：R737.33[医药卫生—肿瘤]