人乳头瘤病毒DNA、E6/E7 mRNA及液基薄层细胞学检查对女性宫颈癌的筛查价值  

Screening value of human papilloma virus DNA,E6/E7 mRNA,and thin-prep cytology test for female cervical cancer

作　　者：刘德美[1] 董晓彤 柳林[2] 李秀凤 王慧 陈国华[3] 张云香[1] LIU Demei;DONG Xiaotong;LIU Lin;LI Xiufeng;WANG Hui;CHEN Guohua;ZHANG Yunxiang(Precision Pathological Diagnosis Center,Weifang People’s Hospital,Weifang 261041,Shandong,China;Department of Gynecology,Weifang People’s Hospital,Weifang 261041,Shandong,China;Health Management Center,Weifang People’s Hospital,Weifang 261041,Shandong,China)

机构地区：[1]潍坊市人民医院精准病理诊断中心,山东潍坊2610410 [2]潍坊市人民医院妇科,山东潍坊2610410 [3]潍坊市人民医院健康管理中心,山东潍坊2610410

出　　处：《癌症进展》2024年第13期1451-1455,1469,共6页Oncology Progress

基　　金：山东省医药卫生科技发展计划项目(2017WS807)。

摘　　要：目的探讨人乳头瘤病毒(HPV)DNA、E6/E7 mRNA及液基薄层细胞学检查(TCT)对女性宫颈癌的筛查价值。方法选取28021例体检女性,均接受HPV DNA、E6/E7 mRNA和TCT单项或多项检测,记录HPV DNA、E6/E7 mRNA、TCT单独及联合检测对宫颈癌的检出情况。以组织活检结果为金标准,评估HPV DNA、E6/E7 mRNA、TCT单独或联合检测对宫颈癌的筛查价值。结果TCT、HPV DNA、E6/E7 mRNA对宫颈癌的检出率分别为8.8%、26.9%、29.7%。各方法单独检测时,TCT单独检测筛查宫颈癌的特异度最高(85.53%),但灵敏度最低(28.44%),HPV DNA单独检测筛查宫颈癌的灵敏度最高(60.25%)。两种方法联合检测时,HPV DNA+E6/E7 mRNA联合检测筛查宫颈癌的灵敏度最高(81.75%),特异度最低(26.34%),TCT+HPV DNA联合检测筛查宫颈癌的特异度(61.08%)和阴性预测值(57.11%)最高,任意两种方法联合检测筛查宫颈癌的灵敏度、特异度比较,差异均有统计学意义(P﹤0.05)。TCT+HPV DNA+E6/E7 mRNA联合检测筛查宫颈癌的灵敏度、特异度与HPV DNA+E6/E7 mRNA检测比较,差异均无统计学意义(P﹥0.05),但灵敏度高于TCT+E6/E7 mRNA联合检测,特异度低于TCT+E6/E7 mRNA联合检测,差异均有统计学意义(P﹤0.05)。结论HPV DNA检测适合作为女性健康体检者宫颈癌筛查的首选方法,E6/E7 mRNA与TCT检测可作为宫颈癌进一步检查的优选。HPV DNA+E6/E7 mRNA联合检测具有较高的灵敏度和阳性预测值,可作为年轻女性宫颈癌筛查的优选方案,联合检测对提高阳性率及降低假阳性率有帮助。Objective To investigate the screening value of human papilloma virus(HPV)DNA,E6/E7 mRNA,and thin-prep cytology test(TCT)for female cervical cancer.Method A total of 28021 women who underwent physical examination were selected,and all subjects received single or multiple tests for HPV DNA,E6/E7 mRNA,and TCT detection.The detection rate of cervical cancer by HPV DNA,E6/E7 mRNA,and TCT single or combined detection were recorded.The tissue biopsy results as the gold standard,the screening value of HPV DNA,E6/E7 mRNA,and TCT single or combined detection for cervical cancer were evaluated.Result The detection rates of TCT,HPV DNA,E6/E7 mRNA for cervical cancer were 8.8%,26.9%,and 29.7%,respectively.When each method single detection,the specificity(85.53%)for screening cervical cancer of TCT single detection was the highest,but the sensitivity(28.44%)was the lowest,the sensitivity(60.25%)for screening cervical cancer of HPV DNA single detection was the highest.When any two methods combined detection,the sensitivity(81.75%)for screening cervical cancer of HPV DNA+E6/E7 mRNA combined detection was the highest,the specificity(61.08%)and negative predictive value(57.11%)for screening cervical cancer of TCT+HPV DNA combined detection were the highest.The sensitivity and specificity of any two methods combined detection for screening cervical cancer were compared,the differences were statistically significant(P<0.05).The sensitivity and specificity of TCT+HPV DNA+E6/E7 mRNA and HPV DNA+E6/E7 mRNA combined detection for screening cervical cancer were not significantly differences(P>0.05),but the sensitivity of TCT+HPV DNA+E6/E7 mRNA was higher than that of TCT+E6/E7 mRNA combined detection,the specificity was lower than that of TCT+E6/E7 mRNA combined detection,and the differences were statistically significant(P<0.05).Conclusion HPV DNA testing is suitable as the preferred method for cervical cancer screening in female health checkups,while E6/E7 mRNA and TCT testing can be preferred for further examination of cervical cance

关 键 词：人乳头瘤病毒DNA E6/E7 mRNA 液基薄层细胞学检查 宫颈癌 人乳头瘤病毒 

分 类 号：R737.33[医药卫生—肿瘤]