人乳头瘤病毒E6/E7 mRNA检测在宫颈癌筛查中的应用价值  

Application value of human papilloma virus E6/E7 mRNA detection in cervical cancer screening

作　　者：王成[1] 涂琴[2] 汪泉[1] 周英妹 代翔 WANG Cheng;TU Qin;WANG Quan;ZHOU Yingmei;DAI Xiang(Department of Pathology,Jiujiang Maternal and Child Health Hospital,Jiujiang 332000,Jiangxi,China;Department of Obstetrics and Gynecology,Jiujiang Maternal and Child Health Hospital,Jiujiang 332000,Jiangxi,China)

机构地区：[1]九江市妇幼保健院病理科,江西九江3320000 [2]九江市妇幼保健院妇产科,江西九江3320000

出　　处：《癌症进展》2024年第19期2139-2142,共4页Oncology Progress

基　　金：九江市科技计划项目(S2023ZDYFN595)。

摘　　要：目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA检测在宫颈癌筛查中的应用价值。方法选取2000例接受宫颈癌筛查的女性,均接受液基薄层细胞学检查(TCT)和HPV E6/E7 mRNA检测,以阴道镜病理活检结果作为金标准,评估TCT、HPV E6/E7 mRNA定性、HPV E6/E7 mRNA定量单独及联合检测对宫颈癌的诊断价值。结果2000例筛查女性中,正常或炎症1917例,低级别鳞状上皮内病变(LSIL)60例,高级别鳞状上皮内病变(HSIL)14例,宫颈癌9例。TCT检测结果显示,无上皮内瘤变或恶性病变(NILM)1753例,未明确意义的非典型鳞状上皮细胞(ASCUS)/非典型腺细胞(AGC)168例,LSIL 57例,HSIL 13例,宫颈癌9例。HPV E6/E7 mRNA检测结果显示,阳性178例,阴性1822例,随着组织学严重程度的增加,HPV E6/E7 mRNA检测的病毒拷贝数逐渐增加。受试者工作特征(ROC)曲线显示,TCT、HPV E6/E7 mRNA定性、HPV E6/E7 mRNA定量联合检测诊断宫颈癌的曲线下面积(AUC)为0.896(95%CI:0.882~0.909),此时的灵敏度为0.880,特异度为0.836。结论HPV E6/E7 mRNA检测作为宫颈癌初筛方案具有一定的可行性,TCT、HPV E6/E7 mRNA定性、HPV E6/E7 mRNA定量联合检测在宫颈癌筛查中有较高的价值。Objective To explore the application value of human papilloma virus(HPV)E6/E7 mRNA detection in cervical cancer screening.Method A total of 2000 women who underwent cervical cancer screening were selected,all of whom received thin-prep cytology test(TCT)and HPV E6/E7 mRNA detection.Using colposcopy pathological biopsy results was the gold standard,the diagnostic value of TCT and HPV E6/E7 mRNA single and combined detection for cervical cancer were evaluated.Result Among 2000 screened women,1917 cases were normal or inflamed,60 cases of low-grade squamous intraepithelial lesion(LSIL),14 cases of high-grade squamous intraepithelial lesion(HSIL),and 9 cases of cervical cancer.TCT detection results showed that there were 1753 cases of negative for intraepithelial lesion or malignancy(NILM),168 cases of atypical squamous cells of undetermined significance(ASCUS)/atypical glandular cell(AGC),57 cases of LSIL,13 cases of HSIL,and 9 cases of cervical cancer.HPV E6/E7 mRNA detection results showed that 178 cases were positive,and 1822 cases were negative.As the histological severity increased,the positivity rate and virus copy number were HPV E6/E7 mRNA detection also gradually increased.The receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of TCT,HPV E6/E7 mRNA qualitative,and HPV E6/E7 mRNA quantitative combined detection in the diagnosis of cervical cancer was 0.896(95%CI:0.882-0.909),the sensitivity was 0.880,and the specificity was 0.836.Conclusion The HPV E6/E7 mRNA detection as a preliminary screening protocol for cervical cancer has certain feasibility,and the TCT,HPV E6/E7 mRNA qualitative,and HPV E6/E7 mRNA quantitative combined detection has high value in cervical cancer screening.

关 键 词：人乳头瘤病毒 液基薄层细胞学检查 宫颈癌 筛查 

分 类 号：R737.33[医药卫生—肿瘤]