HPV E6/E7 mRNA联合年龄在宫颈癌筛查HPV-DNA阳性分流中的作用研究  

Study on role of HPV E6/E7 mRNA combined with age in screening HPV-DNA positive shunt for cervical cancer

作　　者：胡晓军 尤小燕 周颖 HU Xiao-jun;YOU Xiao-yan;ZHOU ying(Department of Obstetrics and Gynecology,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属郑州中心医院妇产科,郑州450000

出　　处：《医药论坛杂志》2024年第23期2493-2497,共5页Journal of Medical Forum

摘　　要：目的探讨人乳头瘤病毒(humanpapillomavirus,HPV)E6/E7 mRNA联合年龄在宫颈癌筛查HPV DNA阳性中的分流作用。方法选择2020年1月—2023年1月至郑州大学附属郑州中心医院就诊,有性生活史并要求行宫颈病变筛查者1980例,均行液基薄层细胞学检查(thinprep cytology test,TCT)、HPV-DNA及HPV E6/E7 mRNA三项初级筛查,并对其中伴有高危因素的584例患者行阴道镜下宫颈组织活检,将病理结果作为诊断标准,对HPV E6/E7 mRNA和HPV-DNA在不同年龄组中阳性率的差异,不同病理分级中HPV-DNA及HPV E6/E7 mRNA阳性检出率对比情况,不同年龄组宫颈疾病的发病情况进行分析比较。结果1980例筛查者中HPV-DNA阳性例数346例,总阳性率为17.47%。HPV-DNA感染率最高为20~29岁组,为69.39%,其次为60岁以上组,阳性率为68.57%。同一年龄组中初筛HPV E6/E7 mRNA的阳性率均低于HPV-DNA,各年龄组两组检出率差异有统计学意义(P<0.05)。在慢性炎症及低级别鳞状上皮内病变(low grade squamous inteaepithelial lesions,LSIL)中,HPV E6/E7 mRNA阳性率低于HPV-DNA,差异具有统计学意义(P<0.05)。随着宫颈病变程度升级,HPV E6/E7 mRNA阳性率逐渐升高,差异具有统计学意义(P<0.05)。年轻女性发生高级别鳞状上皮内病变(high grade squamous inteaepithelial lesions,HSIL)及癌的风险较低,随着年龄的增长,宫颈病变程度逐渐升级,差异具有统计学意义(P<0.05)。结论重视年龄因素联合HPV E6/E7 mRNA对HPV-DNA初筛阳性患者的分流作用,制定个性化的临床干预方案。Objective Shunt effect of HPV E6/E7 mRNA combined age in cervical cancer screening for HPV-DNA positivity.Methods A total of 1,980 cases who had a sexual life history and requested cervical lesion screening were selected from January 2020 to January 2023 and visited the Affiliated Zhengzhou Central Hospital of Zhengzhou University.All of them underwent three primary screenings including thinprep cytology test(TCT),HPV-DNA and HPV E6/E7 mRNA.And 584 cases with high-risk factors among them underwent cervical tissue biopsy under colposcopy.Taking the pathological results as the diagnostic criteria,the differences in the positive rates of HPV E6/E7 mRNA and HPV-DNA in different age groups,the comparison of the positive detection rates of HPV-DNA and HPV E6/E7 mRNA in different pathological grades,and the incidence of cervical diseases in different age groups were analyzed and compared.Results Among the 1980 cases,346 cases were HPV-DNA positive,with a total positive rate of 17.47%.The highest HPV-DNA infection rate was 69.39%in the 20-29 years old group,followed by the group over 60 years old,the positive rate was 68.57%.In the same age group,the positive rate of HPV E6/E7 mRNA in primary screening was lower than that of HPV-DNA,and the difference in detection rate between the two groups in each age group was statistically significant(P<0.05).In chronic inflammation and LSIL lesions,the positive rate of HPV E6/E7 mRNA was lower than that of HPV-DNA,with statistical significance.With the upgrading of cervical lesions,The positive rate of HPV E6/E7 mRNA showed a gradual increase,and the difference was found to be statistically significant(P<0.05).The risk of HSIL and cancer was lower in young women,but the degree of cervical lesions gradually escalated with the grow older,The disparity exhibited statistical significance(P<0.05).Conclusion Attaching importance to age factor,combined with HPV E6/E7 mRNA,patients with HPV-DNA preliminary screening positive were shunted,and personalized clinical intervention programs were

关 键 词：年龄 HPV E6/E7 mRNA HPV-DNA 宫颈癌筛查 

分 类 号：R711.74[医药卫生—妇产科学]