DH3-HPV DNA与Aptima HPV E6/E7 mRNA检测在子宫颈病变中的对比研究  

Comparative Study of DH3-HPV DNA and Aptima HPV E6/E7 mRNA Testing in the Detection of Cervical Lesions

作　　者：顾雨佳 吕炳建[1] GU Yujia;LV Bingjian(Department of Pathology,Women′s Hospital,School of Medicine,Zhejiang University,Hangzhou Zhejiang 310006,China)

机构地区：[1]浙江大学医学院附属妇产科医院病理科,浙江杭州310006

出　　处：《实用妇产科杂志》2025年第4期336-340,共5页Journal of Practical Obstetrics and Gynecology

摘　　要：目的:探究DH3-人乳头瘤病毒(HPV)DNA和Aptima HPV E6/E7 mRNA检测在发现子宫颈病变中的应用价值。方法:回顾性收集2022年1月1日至2023年12月31日在浙江大学医学院附属妇产科医院行DH3-HPV DNA、Aptima HPV E6/E7 mRNA检测病例各1254、8263例,均有子宫颈活检病理随访结果。以子宫颈活检病理结果为金标准,比较DH3-HPV DNA和Aptima HPV E6/E7 mRNA检测低级别鳞状上皮内病变及以上子宫颈病变(LSIL^(+))、高级别鳞状上皮内病变及以上子宫颈病变(HSIL+)的敏感度和特异度。结果:DH3-HPV DNA检测阳性率75.44%(946/1254),Aptima HPV E6/E7 mRNA检测阳性率79.29%(6552/8263)。在年龄≥55岁女性人群中,Aptima HPV E6/E7 mRNA检测阳性率显著高于DH3-HPV DNA[84.70%(1583/1869)vs.76.34%(200/262),P<0.05]。DH3-HPV DNA、Aptima HPV E6/E7 mRNA检测LSIL^(+)的敏感度分别为90.63%(493/544)、91.79%(2953/3217),差异无统计学意义(P>0.05)。DH3-HPV DNA 16/18、Aptima HPV E6/E7 mRNA 16/18/45分型检测LSIL^(+)特异度分别为83.94%(596/710)、85.67%(4323/5046),差异无统计学意义(P>0.05)。DH3-HPV DNA、Aptima HPV E6/E7 mRNA检测HSIL+的敏感度分别为93.94%(124/132)、97.51%(782/802),差异无统计学意义(P>0.05)。Aptima HPV E6/E7 mRNA 16/18/45分型检测HSIL+特异度83.50%(6230/7461),显著高于DH3-HPV DNA 16/18分型检测81.02%(909/1122),差异有统计学意义(P<0.05)。结论:DH3-HPV DNA与Aptima HPV E6/E7 mRNA检测子宫颈病变中敏感度相似,而Aptima HPV E6/E7 mRNA分型检测HSIL+的特异度高于DH3-HPV DNA分型检测;55岁以上女性,Aptima HPV E6/E7 mRNA检测阳性率高于DH3-HPV DNA,可能提示该年龄段人群HPV整合率较高。Objective:To evaluate the clinical value of DH3 human papilloma virus(HPV)DNA and Aptima HPV E6/E7 mRNA testing in detecting cervical lesions.Methods:Retrospective analysis included 1254 cases tested with DH3-HPV DNA and 8263 cases tested with Aptima HPV E6/E7 mRNA from January 1,2022 to December 31,2023 at Women′s Hospital,School of Medicine,Zhejiang University.All patients have follow-up results of cervical biopsy pathology.Cervical biopsy histopathology served as the gold standard.The sensitivity and specificity for detecting low-grade squamous intraepithelial lesion and higher cervical lesions(LSIL^(+))or highgrade squamous intraepithelial lesion and higher cervical lesions(HSIL+)were compared between the two methods.Results:The positive prevalence was 75.44%(946/1254)in DH3-HPV DNA testing,and 79.29%(6552/8263)in Aptima HPV E6/E7 mRNA testing.In women older than 55 years,Aptima HPV E6/E7 mRNA showed a higher positive rate than that of DH3-HPV DNA[84.70%(1583/1869)vs.76.34%(200/262),P<0.05).The sensitivity of DH3-HPV DNA and Aptima HPV E6/E7 mRNA detection of LSIL^(+)was 90.63%(493/544)and 91.79%(2953/3217),respectively,with no statistically significant difference(P>0.05).The specificity of DH3-HPV DNA and Aptima HPV E6/E7 mRNA 16/18 geneotyping detection using LSIL^(+)was 83.94%(596/710)and 85.67%(4323/5046),respectively,with no statistically significant difference(P>0.05).The sensitivity of DH3-HPV DNA and Aptima HPV E6/E7 mRNA detection for HSIL+lesions was 93.94%(124/132)and 97.51%(782/802),respectively,with no statistically significant difference(P>0.05).The specificity of Aptima HPV E6/E7 mRNA 16/18/45 geneotyping detection using HSIL+was 83.50%(6230/7461),significantly higher than that of DH3-HPV DNA 16/18 geneotyping detection at 81.02%(909/1122),with statistically significant difference(P<0.05).Conclusions:The sensitivity of DH3-HPV DNA and Aptima HPV E6/E7 mRNA in the detection of cervical lesions is similar.Aptima HPV E6/E7 mRNA geneotyping has a high specificity in the detection of HSIL+than DH3

关 键 词：子宫颈癌 鳞状上皮内病变 人乳头瘤病毒E6/E7 mRNA 人乳头瘤病毒分型 人乳头瘤病毒DNA 

分 类 号：R737.33[医药卫生—肿瘤] R446[医药卫生—临床医学]