人乳头瘤病毒E6/E7 mRNA检测在宫颈早期癌变的临床应用  

Clinical application of detection of human papillomavirus E6/E7 mRNA in early cervical carcinoma

作　　者：张玲玲 杨书才 黄伟忠 张鲍虎 ZHANG Lingling;YANG Shucai;HUANG Weizhong;ZHANG Baohu(Department of Clinical Laboratory,Shenzhen Pingshan People’s Hospital,Guangdong,Shenzhen 518118,China)

机构地区：[1]深圳市坪山区人民医院检验科,广东深圳518118

出　　处：《中国医药科学》2023年第19期144-147,共4页China Medicine And Pharmacy

摘　　要：目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA检测在宫颈早期癌变的临床应用。方法选取深圳市坪山区人民医院妇科2021年1月至2022年1月收治的可疑宫颈病变早筛患者1200例作为研究对象。早筛方式包括宫颈液基细胞学(TCT)检查、HPV E6/E7 mRNA检测以及阴道镜下病理活检。分析HPV E6/E7 mRNA检测在宫颈早期癌变中的诊断价值。结果所有样本中178例样本来源于正常宫颈组织,682例为炎性组织,332例确诊为宫颈癌前病变(CIN)Ⅰ级,另有8例确诊为CINⅡ~Ⅲ级,无宫颈浸润癌样本。总体HPV E6/E7 mRNA阳性样本508例,阳性率42.33%,HPV E6/E7 mRNA定量分析(经对数转换)范围1.56~3.78,平均(2.25±0.39)。不同病理结果患者的HPV E6/E7 mRNA定性和定量分析结果,差异均有统计学意义(P<0.05)。病理样本与HPV E6/E7 mRNA定性分析对CIN患者诊断结果的Kappa值为0.486,差异有统计学意义(P<0.05)。结论作为编码致癌蛋白的E6/E7基因,在正常宫颈组织及炎性宫颈组织中的表达较低,而在CIN组织中的表达显著上调。其定性检验对宫颈早期癌变诊断的效能较好,与病理活检的一致性中等,且为无创操作,值得推广应用。Objective To explore the clinical application of detection of human papilloma virus(HPV)E6/E7 mRNA in early cervical carcinoma.Methods A total of 1200 patients with suspected cervix lesions admitted to the Department of Gynecology,Shenzhen Pingshan People’s Hospital from January 2021 to January 2022 were selected as the study subjects.Early screening methods included cervical thinprep cytologic test(TCT),HPV E6/E7 mRNA detection and colposcopic pathological biopsy.The diagnostic value of the HPV E6/E7 mRNA test in early cervical carcinoma was analyzed.Results Of all samples,178 were from normal cervical tissue,682 were inflammatory tissue,332 were diagnosed with a precancerous lesion of cervix(CIN)gradeⅠand 8 were diagnosed with CIN gradeⅡ-Ⅲ,with no cervical invasive cancer samples.Overall,there were 508 positive samples for HPV E6/E7 mRNA,with a positive rate of 42.33%.Quantitative analysis of HPV E6/E7 mRNA(log-transformed)ranged from 1.56 to 3.78,with a mean of(2.25±0.39).There was a statistically significant difference between the qualitative and quantitative analysis of HPV E6/E7 mRNA in patients with different pathological outcomes(P<0.05).The Kappa value of the pathological samples with qualitative analysis of HPV E6/E7 mRNA for the diagnosis of CIN patients was 0.486,a statistically significant difference(P<0.05).Conclusion The E6/E7 genes,which encode oncogenic proteins,are lowly expressed in normal and inflamed cervical tissues,while their expression is significantly up-regulated in CIN tissues.Its qualitative test has good efficacy for the diagnosis of early cervical cancer and has moderate concordance with pathological biopsies.Besides,it is a non-invasive operation and is worth promoting and applying.

关 键 词：人乳头瘤病毒 宫颈早期癌 宫颈液基细胞学 预后 

分 类 号：R737.33[医药卫生—肿瘤]