人乳头瘤病毒HPV E6/E7 mRNA检测在宫颈病变诊断中的价值

Value of human papillomavirus E6/E7 mRNA detection in diagnosis of cervical lesions

目的：评估HPV E6/E7 mRNA在宫颈病变诊断中的价值。方法：选取弋矶山医院2014年9月~2015年9月HPV DNA阳性且TCT检测为慢性宫颈炎患者197例,行HPV E6/E7 mRNA及阴道镜下宫颈组织病理学检测。结果：197例HPV阳性患者中,HPV E6/E7 mRNA的阳性率为62.44%,敏感度为91.18%,特异度为52.17%,阳性预测值为50.14%,阴性预测值为91.89%。不同组织学分级中,HPV E6/E7 mRNA的阳性表达率在宫颈炎组与CINⅠ组、宫颈炎组与Ⅱ组、宫颈炎组与Ⅲ组均具有统计学差异（P〈0.01）。HPV E6/E7 mRNA检测与病理学诊断符合率为90%。结论：HPV E6/E7mRNA的表达与宫颈病变密切相关,可用于评估宫颈癌的发病风险。在早期或低级别病变中,HPV E6/E7 mRNA检测对预测高级别宫颈上皮内瘤变的发生有着重要作用。

Objective： To assess the value of human papilloma virus（ HPV） E6 /E7 mRNA detection in the diagnosis of cervical lesions. Methods： A total of 197 HPV positive cases confirmed as chronic cervicitis by Thin-prep liquid-based Cytology Test（ TCT） were included from Yijishan Hospital of Wannan Medical College between September of 2014 and 2015,and all patients were given further detection of HPV E6 / E7 mRNA as well as colposcopy and cervical biopsy. Results： In the 197 cases,positive HPV E6 / E7 mRNA was 62. 44%,and mRNA sensitivity was 91. 18%; specificity,52. 17%; positive predictive value,50. 14%; negative predictive value,91. 89%. By histological grading,the difference was significant regarding the positive rate of HPV E6 /E7 mRNA between inflammatory group and cervical intraepithelial neoplasia（ CIN） Ⅰ,CIN Ⅱor CIN Ⅲ（ P〈0. 01）. The result of HPV E6 / E7 mRNA expression was consistent with that of pathological findings in 90% of the cases. Conclusion： HPV E6 / E7 mRNA expression is closely correlated with cervical lesions,and can be a useful tool to assess the risks of malignancy. Particularly,HPV E6 / E7 mRNA detection can competently predict high grade CIN from early or low grade cervical lesions.