HPV E6/E7 mRNA检测在ASC-US患者分层处理中的应用研究

Application of HPV E6/E7 mRNA test in hierarchical processing of ASC-US

目的 探讨HPV E6/E7 mRNA检测在意义不明确的宫颈不典型鳞状上皮细胞（ASC-US）患者分层处理中的应用.方法 对312例薄层液基细胞学检查结果为ASC-US的患者进行HPV E6/E7mRNA检测.结合病理诊断资料,进行统计学分析.结果 312例患者中,上皮细胞正常或炎症样变211例（67.63％）,其中HPVE6/E7mRNA阳性率为43.40％（92/211）;低度鳞状上皮内病变（LSIL）66例（21.15％）,其中HPV E6/E7 mRNA阳性率为71.21％ （47/66）;高度鳞状上皮内病变（HSIL）35例（11.22％）,其中HPV E6/E7 mRNA阳性率为91.18％ （32/35）.HPV E6/E7 mRNA对LSIL/HSIL的诊断敏感性为78.22％,特异性为56.40％,阳性预测值为46.20％,阴性预测值为84.40％.结论 HPV E6/E7 mRNA检测可以应用于ASC-US患者分层处理,避免对宫颈高度病变的漏诊.

Objective To investigate the application of human papilloma virus （HPV） E6/E7 mRNA test to process atypical squamous cells of undetermined significance （ASC-US） in layers. Methods 312 patients with ASC-US underwent HPV E6/E7 mRNA test. The pathology data was statistically analyzed. Results Stratified by pathology, the positive rate of HPV E6/E7 mRNA was 43.40% in 211 patients （67.63%） with inflammation or normal, 71.21% in 66 patients （21.15%） with LSIL （low-grade squamous intraepithelial lesion） and 91.18% in 35 patients （11.22%） with HSIL （high-grade squamous intraepithelial lesion）. Among the detection efficiency of HPV E6/E7 mRNA test for ISIL/HSIL, the sensitivity was 78.22%, the specificity was 56.40%, positive predictive value （PPV） was 46.20%, and negative predictive value （NPV） was 84.40%. Conclusion HPV E6/E7 mRNA test can be well used in hierarchical processing of ASC-US to avoid the misdiagnosis of high-grade cervical lesion.