人乳头瘤病毒E6/E7 mRNA的检测在宫颈癌筛查中的初步评价

Preliminary evaluation of detection of human papilloma virus E6/E7 mRNA in screening of cervical cancer

目的:评价支链DNA技术(bDNA)对HPV-E6/E7 mRNA的检测及其临床价值。方法:对167例宫颈癌筛查妇女宫颈脱落细胞用液基细胞薄层涂片技术行宫颈细胞学检查,同时采用bDNA技术检测HPV-E6/E7 mRNA。另从中随机选择43例患者[11例非典型磷状上皮细胞(ASCUS)、17例低度磷状上皮内病变(LSIL)、15例高度磷状上皮内病变(HSIL)]检测HPV-E6/E7DNA。结果:①HPV-E6/E7 mRNA与HPV-E6/E7 DNA相关性分析显示:HPV-E6/E7 mRNA与HPV-E6/E7 DNA检测结果呈现显著正相关(r=0.465,P=0.002);②总体人群HPV-E6/E7 mRNA检出阳性率为43.1%,随着病理级别的升高,HPV-E6/E7mRNA阳性率(χ2=41.396,P<0.001)和copies量(H=39.350,P<0.001)均呈现趋势性升高;③HPV-E6/E7 mRNA对LSIL+诊断的灵敏度为67.1%(95%CI:56.1%-78.1%)、特异性为74.2%(95%CI:65.5%-82.9%)、准确性为71.3%(95%CI:64.4%-78.1%)、阳性预测值为65.3%(95%CI:54.3%-76.3%)、阴性预测值为75.8%(95%CI:67.2%-84.4%)。结论:HPV-E6/E7 mRNA与宫颈细胞学类型相关,其对LSIL+的诊断具有较高的效率,可能更为适用于宫颈癌的发病风险评估。

Objective：To investigate the clinical value of human papiiloma virus E6/E7 mRNA by branch-DNA technology. Methods：In the exfoliated cervical cells form 167 women of cervical cancer screening by liquid based thinprep cytology test（TCT）, braneh-DNA （bDNA） technology was performed to examine the HPV-E6/E7 mRNA. The HPV-E6/E7 DNA was also examined in 43 cases at the same time. Results： （1）The copies of HPV-E6/E7 mRNA are positively related with HPV-E6/E7 DNA （r = 0.465,P = 0.002）; （2）The HPV-E6/E7 mRNA positive rate was 43.1% in all groups. The HPV-E6/E7 mRNA positive rate and copies were increased along with the increase of the grade of cervical lesions（Х^2 = 41.396,P 〈 0.001 ; H = 39.350,P 〈 0.001） ;（3）The sensitivity, specificity, accuracy, positive predictive value, negative predictive value of HPV-E6/E7 mRNA for LSIL^＋ were 67.1% （95%CI, 56.1% to 78.1%）,74.2%（95%CI,65.5% to 82.9%）,71.3%（95%CI,64.4% to 78.1%）,65.3%（95%CI,54.3% to 76.3%） and 75.8% （95% CI,67.2% to 84.4%）,respectively. Conclusion：The HPV-E6/E7 mRNA was related with the type of cervix cytology,and had high efficiency diagnose for LSIL^＋. The HPV-E6/E7 mRNA can be applied for risk assessment of cervical cancer.