高危型 HPV E6/E7mRNA和HPV DNA筛查宫颈病变效能比较  

Comparison of the screening efficacy of the high risk HPV E6/E7 mRNA and HPV DNA for the cervical lesions of patients

作　　者：谢艺溶 顾海娜[1] XIE Yilong;GU Haina(Zhoushan Maternal and Child Health Care Hospital,Zhoushan,Zhejiang Province,316000)

机构地区：[1]浙江省舟山市妇幼保健院,316000

出　　处：《中国计划生育学杂志》2023年第4期949-953,共5页Chinese Journal of Family Planning

摘　　要：目的:探究高危型人乳头瘤病毒(HPV)E6/E7mRNA和HPV DNA检测在宫颈病变诊断效果。方法:收集2020年10月-2021年10月本院妇科门诊因接触性出血、阴道不规则出血、阴道排液等或常规体检行TCT检查不典型鳞状细胞(ASCUS)级别及以上100例为研究对象,同时行HPV E6/E7mRNA、HPV DNA检测及阴道镜指下宫颈活检,将活检组织病理学诊断作为的标准。分析高危HPV亚型中E6/E7 mRNA和HPV DNA表达水平,并比较二种检测在各细胞学、组织学的检出率等。结果:以细胞学诊断为标准,HPV E6/E7 mRNA阳性率与HPV DNA阳性率无差异(P>0.05)。以病理为金标准,发现两种检测在CIN2+的检测阳性率均高于慢性宫颈炎组以及CIN1级,其中慢性宫颈炎检测上HPV DNA的阳性率高于HPV E6/E7 mRNA阳性率,HPV DNA的总体阳性率也高于HPV E6/E7 mRNA阳性率(均P<0.05)。以病理为金标准,CIN1级为阴性,CIN2+为阳性,HPV E6/E7 mRNA检测的特异性(84.2%)高于HPV DNA检测(51.4%),阳性预测值(71.7%)与符合率(81.8%)均高于HPV DNA检测(45.2%、62.1%)(均P<0.05),两种检测方法灵敏度及阴性预测值无差异(P>0.05)。结论:HPV E6/E7 mRNA检测可以提高宫颈病变筛查的特异性和阳性预测值,可为宫颈病变分流管理提供指导。Objective:To explore the screening efficacy of the high risk human papilloma virus(HPV)E6/E7 mRNA and HPV DNA for the cervical lesions of patients.Methods:100 patients with positive TCT result as atypical squa-mous cell of undetermined significant(ASCUS)or above in routine physical examination,or the patients with contact bleeding,irregular vaginal bleeding,or vaginal abnormal discharge from October 2020 to October 2021 were collected.The detections of HPV E6/E7 mRNA and HPV DNA and the cervical biopsy under the guidance of colposcopy of these patients were performed at the same time,and biopsy histopathology was used as the gold standard of the diagnosis of the cervical lesions.The expression levels of E6/E7 mRNA and DNA of high-risk subtypes HPV were analyzed.The detection rates of the cytology and histology were compared between the two detections of E6/E7 mRNA and DNA of highrrisk subtypes HPV.Results:Based on the result of cytological diagnosis,there was no significant differences in.the positive rates of HPV E6/E7 mRNA and HPV DNA(P>0.05).Based on the result of pathology as the gold standard,the positive rate of the detections of HPV E6/E7 mRNA and HPV DNA of the patients with>grading 2 of cervical intraepithelial neoplasia(CIN)was significantly higher than that of the patients with chronic cervicitis group or with grading 1 of CIN.The positive rate of HPV DNA detection of the patients with chronic cervicitis was significantly higher than that of HPV E6/E7 mRNA detection.The overall positive rate of HPV DNA detection of the patients was also significantly higher than that of HPV E6/E7 mRNA detection(all P<0.05).The results of pathology as the gold standard,the specificity(84.2%),the positive predictive value(71.7%),and the coincidence rate(81.8%)of HPV E6/E7 mRNA detection for screening the cervical lesions were significantly higher than those(51.4%,45.2%,and 62.1%)of HPV DNA detection(all P<0.05),and there were no significant differences in the sensitivity and the neg-ative predictive value between the two

关 键 词：宫颈癌 高危人乳头瘤病毒 筛查 E6/E7 mRNA DNA 

分 类 号：R737.33[医药卫生—肿瘤]