自噬相关基因、人乳头瘤病毒联合阴道镜Reid评分对宫颈癌变的诊断价值  

Value of combined use of autophagy-related gene,human papilloma virus and the Reid colposcopic index in the diagnosis of cervical cancer

作　　者：程欣 朱佩茹[1] 曹蕾[1] CHENG Xin;ZHU Peiru;CAO Lei(Department of Obstetrics and Gynecology,Henan Provincial People′s Hospital,Zhengzhou 450008,Henan Province,China)

机构地区：[1]河南省人民医院妇产科,河南郑州450008

出　　处：《新乡医学院学报》2025年第5期410-414,共5页Journal of Xinxiang Medical University

摘　　要：目的 探讨自噬相关基因(Beclin-1)、人乳头瘤病毒(HPV)以及阴道镜Reid评分对宫颈癌变的诊断价值。方法 选择2022年1月至2024年1月于河南省人民医院行妇科宫颈癌筛查的600例患者为研究对象。患者均接受宫颈细胞学检查(TCT)、阴道镜检查。采用实时荧光定量聚合酶链反应(RT-qPCR)测定宫颈组织中Beclin-1,聚合酶链反应结合膜杂交法检测HPV的表达情况,应用阴道镜行Reid评分检查。以组织病理结果为诊断金标准,比较Beclin-1水平、HPV、阴道镜Reid评分单项和三者联合检测的阳性率以及不同检测方法诊断的敏感度、特异度、准确率、漏诊率和误诊率,采用Kappa检验不同检测方法对早期宫颈癌及癌前病变筛查诊断与组织病理诊断的一致性。结果 以组织病理学诊断为金标准,Beclin-1、HPV、RCI评分联合诊断宫颈癌的真阳性率为48.50%(291/600),Beclin-1诊断宫颈癌变的真阳性率为32.17%(193/600),HPV诊断宫颈癌变的真阳性率为42.16%(253/600),RCI评分诊断宫颈癌变的真阳性率为35.16%(211/600);Beclin-1、HPV、RCI评分联合诊断宫颈癌变的真阳性率显著高于Beclin-1、HPV、RCI评分单独诊断(P<0.05)。Beclin-1、HPV、RCI评分联合诊断的灵敏度、特异度、准确率、阳性预测值和阴性预测值均高于Beclin-1、HPV、RCI评分法单独诊断(P<0.05)。Kappa检验结果显示,Beclin-1、HPV联合RCI评分诊断宫颈癌变与金标准具有高度一致性(Kappa=0.970,P<0.05),且其一致性程度显著高于Beclin-1(Kappa=0.282,P<0.05)、HPV(Kappa=0.665,P<0.05)和RCI评分(Kappa=0.415,P<0.05)。Beclin-1、HPV、RCI评分联合诊断的阳性预测值和阴性预测值显著高于三者单独诊断,漏诊率和误诊率显著低于三者单独检测(P<0.05)。结论 Beclin-1、HPV联合阴道镜RCI评分对早期宫颈癌及癌前病变有较高诊断价值,可提高诊断准确性,有效降低漏诊率和误诊率,为早期治疗宫颈癌提供可靠的参考依据。Objective To explore the value of autophagy-related gene(namely,Beclin-1),human papilloma virus(HPV)and the Reid colposcopic index(RCI)score in the diagnosis of cervical cancer.Methods A total of 600 patients who underwent gynaecological cervical cancer screening at Henan Provincial People′s Hospital from January 2022 to January 2024 were included in the study.The patients took a ThinPrep cytologic test(TCT)and a colposcopy.Quantitative real-time polymerase chain reaction(RT-qPCR)was used to determine the expression of Beclin-1 in cervical tissues.The expression of HPV in cervical tissues was detected by polymerase chain reaction and membrane hybridization.The RCI score was examined by colposcopy.Histopathological results were taken as the gold standard for diagnosis.The positive rates of the Beclin-1 level,HPV,the RCI score,and the combined method of the three were compared.The diagnostic sensitivity,specificity,accuracy,missed diagnosis and misdiagnosis rates of different detection methods were calculated.The Kappa test was used to examine whether the diagnostic results by different detection methods for screening early cervical cancer and precancerous lesions were consistent with histopathological results.Results Taking histopathological results as the golden standard,the positive rate of the combined method of Beclin-1,HPV,and RCI scores for cervical cancer diagnosis was 48.50%(291/600),which was significantly higher than that of Beclin-1[32.17%(193/600)],HPV[42.16%(253/600)]and RCI scores[35.16%(211/600)]alone(P<0.05).In addition,the true positive rate,sensitivity,specificity,accuracy,positive and negative predictive values of the combined method of Beclin-1,HPV and RCI scores for cervical cancer diagnosis were all significantly higher than those of Beclin-1,HPV and RCI scores alone(P<0.05).The Kappa test showed that the diagnostic results of the combined method of Beclin-1,HPV and RCI scores for screening early cervical cancer and precancerous lesions were consistent with the golden standard(Kappa=0.970,P

关 键 词：BECLIN-1 人乳头瘤病毒 阴道镜Reid评分 宫颈癌 诊断 

分 类 号：R737.33[医药卫生—肿瘤]