摘要
目的比较p16/Ki-67双染、HPV E6/E7 mRNA联合检测与单独检测对宫颈癌前病变的检出效能。方法收集2021—2022年接受宫颈癌前病变筛查的患者112例,液基薄层细胞检测(TCT)宫颈细胞的病变情况,并经病理学检查确诊。根据宫颈HPV E6/E7 mRNA检测试剂盒检测宫颈脱落细胞的HPV E6/E7 mRNA水平,利用CINtec PLUS细胞学试剂盒检测宫颈细胞p16/Ki-67双染情况。分析p16/Ki-67双染、HPV E6/E7 mRNA单独或联合检测对宫颈癌前病变检出效能的影响。结果112例宫颈癌前病变筛查患者的病理学结果显示,低度鳞状上皮内病变(LSIL)33例,高度鳞状上皮内病变(HSIL)79例。HPV E6/E7 mRNA阳性72例(64.3%),阴性40例(35.7%);p16/Ki-67双染阳性83例(74.1%),阴性29例(25.9%)。不同癌前病变组间HPV E6/E7 mRNA表达和p16/Ki-67双染间差别均有统计学意义(P<0.05)。不同年龄段癌前病变组间差别有统计学意义(P<0.05),HPV E6/E7 mRNA表达和p16/Ki-67双染间差别无统计学意义(P>0.05)。HPV E6/E7 mRNA联合p16/Ki-67双染检测宫颈癌前病变的敏感度和准确性均高于两者单独检测,阴性预测值高于HPV E6/E7 mRNA单独检测(P<0.05)。两者联合检测HSIL的敏感度、特异度和阳性预测值均高于HPV E6/E7 mRNA单独检测,准确性和阴性预测值均高于两者单独检测。另外,p16/Ki-67双染检测HSIL的敏感度、准确性和阴性预测值均高于HPV E6/E7 mRNA单独检测(P<0.05)。结论HPV E6/E7 mRNA和p16/Ki-67双染联合检测在宫颈癌前病变检出中具有临床价值。
Objective It is to compare the screening efficacy of combined p16/Ki-67 double-staining and HPV E6/E7 mRNA testing with that of testing alone for the detection of cervical precancerous lesions.Methods A total of 112 patients who were screened for cervical precancerous lesion from in 2021-2022 were collected.The lesions of cervical cell were detected by ThinPrep cytologic test(TCT),and the diagnosis was confirmed by pathological examination.The HPV E6/E7 mRNA levels of cervical exfoliated cells were detected by cervical HPV E6/E7 mRNA detection kit,and the p16/Ki-67 double-staining of cervical cells was detected by CINtec PLUS cytology kit.The effects of HPV E6/E7 mRNA and p16/Ki-67 double-staining testing in combination or alone on the screening efficacy of cervical precancerous lesion were analyzed.Results The pathological results of 112 patients screened for cervical precancerous lesions showed 33 cases of low grade squamous intraepithelial lesions(LSIL)and 79 cases of high grade squamous intraepithelial lesions(HSIL).HPV E6/E7 mRNA was positive in 72 cases(64.3%),negative in 40 cases(35.7%),p16/Ki-67 double-staining was positive in 83 cases(74.1%),and p16/Ki-67 double-staining was negative in 29 cases(25.9%).There were statistically significant differences in the results of HPV E6/E7 mRNA expression and p16/Ki-67 double-staining among different precancerous lesion groups(P<0.05).There were statistically significant differences among precancerous lesion groups in different age groups(P<0.05),but there were no significant differences in HPV E6/E7 mRNA expression and p16/Ki-67 double-staining(P>0.05).The sensitivity and accuracy of HPV E6/E7 mRNA combined with p16/Ki-67 double-staining in the detection of cervical precancerous lesions were higher than those of the two alone,and the negative predictive value was higher than that of HPV E6/E7 mRNA detection alone(P<0.05).The sensitivity,specificity and positive predictive value of HPV E6/E7 mRNA combined with p16/Ki-67 double-staining in the detection of HSIL were higher than those of HPV E6/E7 mRNA detection alone,and the accuracy and negative predictive value were higher than those of HPV E6/E7 mRNA or p16/Ki-67 double-staining alone.In addition,the sensitivity,accuracy and negative predictive value of p16/Ki-67 double-staining in the detection of HSIL were higher than those of HPV E6/E7 mRNA detection alone(P<0.05).Conclusion The combined detection of HPV E6/E7 mRNA and p16/Ki-67 double staining has clinical value in the screening of cervical precancerous lesions.
作者
贾巍芳
吴坤英
JIA Weifang;WU Kunying(Department of Obstetrics and Gynecology,Zhengzhou Maternal and Child Health Hospital,Zhengzhou 450012,China)
出处
《福建医科大学学报》
2023年第3期194-198,共5页
Journal of Fujian Medical University
基金
河南省医学科技公关计划联合共建项目(LHGJ20210788)。