头颈部黏膜病损中拭子HPV半定量检测的应用研究  

Application of HPV semi-quantitative detection in swab of head and neck mucosal lesions

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作  者:李齐佳 王哓艳 何雨蓉 李荣佳 史晓钰 丁硕 郭伟[1] 赵延明[1] 房居高[1] 钟琦[1] LI Qijia;WANG Xiaoyan;HE Yurong;LI Rongjia;SHI Xiaoyu;DING Shuo;GUO Wei;ZHAO Yanming;FANG Jugao;ZHONG Qi(Department of Otolaryngology Head and Neck Surgery,Beijing Tongren Hospital,Capital Medical University,Key Laboratory of Otolaryngology Head and Neck Surgery(Capital Medical University),Ministry of Education,Beijing,100730,China)

机构地区:[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,耳鼻咽喉头颈科学教育部重点实验室(首都医科大学),北京100730

出  处:《中国耳鼻咽喉头颈外科》2024年第6期341-345,共5页Chinese Archives of Otolaryngology-Head and Neck Surgery

基  金:北京市科技新星交叉合作课题(20230484484);北京市自然科学基金面上项目(7242039)。

摘  要:目的比较头颈部黏膜病损HPV E6/E7 mRNA的半定量检测与组织中p16免疫组织化学染色及E6/E7RNA原位杂交检测的一致性,探讨应用咽拭子检出头颈部黏膜病损中高危型HPV感染的可行性。方法收集2022年9月~2023年8月首都医科大学附属北京同仁医院头颈外科经治的头颈部黏膜病损患者100例,进行口咽、病损表面拭子和病损组织标本HPV E6/E7 mRNA的半定量检测和病损组织的p16免疫组织化学染色、E6/E7 mRNA原位杂交检测,并对不同检测结果的一致性和差异性进行研究。结果100例患者中,符合纳排标准者共83例,其中乳头状瘤21例、息肉/慢性炎症10例、喉癌19例、口咽癌13例、下咽癌20例。口咽拭子和病损表面拭子的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色结果表现为中度或接近高度的一致性,而病损组织的HPV E6/E7 mRNA半定量检测结果与p16免疫组织化学染色表现为高度的一致性(Kappa=0.780);在诊断效能分析中,两种拭子均表现出与HPVE6/E7mRNA原位杂交高度的一致性(Kappa=0.690、0.708)。结论在头颈部黏膜病损中,口咽和病损表面拭子的HPV半定量检测结果与经典的p16免疫组织化学染色及“金标准”HPV E6/E7 mRNA原位杂交相比较具有较好的一致性,是一种简便可靠的临床高危型HPV检出方法,有助于头颈部黏膜病损HPV感染的筛查和个体化精准防控。OBJECTIVE To compare the consistency between the semi-quantitative detection of HPV E6/E7 mRNA and the detection of p16 IHC and E6/E7RNA ISH in the tissues,and the feasibility of detecting high-risk HPV in head and neck mucosal lesions by HPV E6/E7 mRNA detection in the swabs was discussed.METHODS A total of 100 cases of head and neck mucosal lesions treated by the Department of Head and Neck Surgery,Beijing Tongren Hospital Affiliated to Capital Medical University from September 2022 to August 2023 were collected.Semi-quantitative detection of HPV E6/E7 mRNA was performed in oropharynx,lesion surface swab and lesion tissue specimen,and p16 immunohistochemical staining(IHC)and E6/E7 mRNA in situ hybridization(ISH)were detected in lesion tissue,and the consistency and difference of different detection results were studied.RESULTS Among the 100 patients,83 met the inclusion criteria and were divided into 21 papilloma cases,10 polyps/chronic inflammation cases,19 laryngeal cancer cases,13 oropharyngeal cancer cases,and 20 hypopharyngeal cancer cases according to pathological diagnosis.The HPV E6/E7 mRNA semi-quantitative results of oropharyngeal swab and lesion surface swab showed moderate or near high consistency with p16 IHC results.The results of HPV E6/E7 mRNA semi-quantitative in diseased tissue were highly consistent with those of p16 IHC(Kappa=0.780).In the diagnostic efficacy analysis,both swabs showed high consistency with HPV E6/E7 mRNA ISH(Kappa=0.690 and 0.708).CONCLUSION In the head and neck mucosal lesions,the HPV semi-quantitative detection results of oropharyngeal and lesion surface swab showed good consistency compared with classical p16 IHC and gold standard HPV E6/E7 mRNA ISH.It is a simple and reliable method for clinical high-risk HPV detection,which is helpful for the screening and individualized precise prevention and control of HPV infection in head and neck mucosal lesions.

关 键 词:头颈部肿瘤 免疫组织化学 原位杂交 人乳头状瘤病毒 HPVE6/E7 

分 类 号:R739.91[医药卫生—肿瘤]

 

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