HPV E6/E7 mRNA检测对HPV16/18 DNA阳性患者的分流价值  

Shunt Value of HPV E6/E7 mRNA Detection in HPV16/18 DNA Positive Patients

作　　者：王意[1] 李子珊[1] 雷雯 黄淑君[2] 彭盼 WANG Yi;LI Zi-shan;LEI Wen;HUANG Shu-jun;PENG Pan(Department of Maternal Health Care,Guangdong Maternal and Child Health Hospital,Guangzhou 511400,Guangdong,China;Institute of Women and Children's Health,Guangdong Maternal and Child Health Hospital,Guangzhou 511400,Guangdong,China;Guangzhou Baochang Biotechnology Co.,LTD.,Guangzhou 511400,Guangdong,China)

机构地区：[1]广东省妇幼保健院妇女保健科,广东广州511400 [2]广东省妇幼保健院妇女儿童健康研究所,广东广州511400 [3]广州市宝创生物技术有限公司,广东广州511400

出　　处：《医学信息》2024年第18期57-64,共8页Journal of Medical Information

基　　金：广东省中医药局科研项目(编号:20221043)。

摘　　要：目的探讨HPV E6/E7 mRNA对HPV16/18 DNA阳性患者的分流价值。方法收集127例HPV16/18 DNA阳性的核酸样本,行HPV E6/E7 mRNA检测,并结合宫颈液基细胞学(TCT)结果和病理诊断结果进行统计分析。结果(1)HPV E6/E7mRNA检出型别以单一感染为主,占比81.93%。年龄分布显示呈双峰状。(2)HPV E6/E7 mRNA总阳性率为65.35%,且随着宫颈病变程度升高,HPV E6/E7 mRNA阳性率升高。且LSIL组与炎症组,HSIL+组与炎症组阳性率比较,差异有统计学意义(P<0.05)。(3)对HPV 16/18 DNA阳性者,用细胞学进一步分流,可以减少65.35%的阴道镜检查,漏诊44.83%的HSIL+;采用HPV E6/E7 mRNA进行分流,可以减少34.65%的阴道镜检查,漏诊10.34%的HSIL+;HPV E6/E7 m RNA分流漏诊率低于TCT分流方法,差异有统计学意义(P<0.05)。(4)HPV16/18 DNA阳性且细胞学检查为≥ASC-US的患者,经HPV E6/E7 m RNA分流,可减少11.36%的阴道镜检查,无漏诊HSIL+。结论HPV16/18 DNA阳性者进一步用TCT联合HPV E6/E7 m RNA进行同步分流,可以减少阴道镜检查,同时降低≥ASC-US的患者漏诊HSIL+的风险。Objective To investigate the value of HPV E6/E7 mRNA in the shunt of HPV16/18 DNA positive patients.Methods A total of 127 cases of HPV16/18 DNA positive nucleic acid samples were collected,and HPV E6/E7 mRNA was detected.The results were statistically analyzed in combination with the results of thinprepcytologic test(TCT)and pathological diagnosis.Results①The HPV E6/E7 mRNA was detected by mainly single infection,accounting for 81.93%.The age distribution showed a bimodal shape.②The total positive rate of HPV E6/E7 mRNA was 65.35%.With the increase of cervical lesions,the positive rate of HPV E6/E7 mRNA increased,while the positive rate of LSIL group and inflammation group,HSIL+group and inflammation group was statistically significant(P<0.05).③As the HPV 16/18 DNA positivity triage test,Cytology at the ASC-US+threshold could reduce colposcopy by 65.35%,but missed diagnosis of HSIL+by 44.83%;whereas HPVE6/E7 mRNA could reduce the colposcopy by 34.65%,and missed diagnosis of HSIL+by 10.34%.As a triage test in HPV 16/18 DNA positivity patients,the missed diagnosis rate of HPV E6/E7 mRNA was lower than that of TCT(P<0.05).④As a triage test,in patients with HPV16/18 DNA positive and cytological grades≥ASC-US,E6/E7 mRNA could reduce the colposcopy by 11.36%and none missed diagnosis of HSIL+.Conclusion TCT combined with HPV E6/E7 mRNA for synchronous shunt in HPV16/18 DNA positive patients can reduce colposcopy and the risk of missed diagnosis of HSIL+in patients with≥ASC-US.

关 键 词：HPV E6/E7 mRNA HPV TCT 高级别鳞状上皮内瘤变 

分 类 号：R737.33[医药卫生—肿瘤]