宫颈癌患者治疗前检测血清HPV16E6 mRNA和CK19 mRNA的临床意义

Clinical Significance of Examination of Pretreatment Peripheral Blood HPV16E6 mRNA and CK19 mRNA in Cervical Cancer Patients

目的检测宫颈癌患者治疗前外周血HPV16E6m RNA和CK19m RNA的表达,探讨其对宫颈癌的诊断意义及其与临床病理的相关性.方法对100例宫颈癌患者行治疗前外周血HPV16E6m RNA及CK19m RNA检测,以40例健康妇女为对照,分析其作为诊断参考的特异性和敏感性,并对两者与宫颈癌临床病理特征的相关性进行分析.结果 HPV16E6m RNA、CK19m RNA检测诊断宫颈癌的特异性均为97.5%.HPV16E6m RNA、CK19m RNA升高用于治疗前诊断的敏感性分别为15%和39%,两者差异有统计学意义(P<0.05).HPV16E6m RNA升高与临床分期(P=0.012)、盆腔淋巴结转移(P=0.026)相关.CK19m RNA升高与深肌层浸润(P=0.031)、盆腔淋巴结转移(P=0.027)相关.结论外周血HPV16E6m RNA和CK19m RNA均是宫颈癌微转移有价值的肿瘤标志物;CK19m RNA在作为宫颈癌指标时,临床诊断价值优于HPV16E6m RNA.

Objective To investigate the significance of pretreatment peripheral blood HPV16E6m RNA and CK19m RNA in diagnosis and their correlations to the clinicopathologic features of cervical carcinoma. Methods One hundred cervical carcinoma patients underwent pretreatment peripheral blood HPV16E6m RNA and CK19m RNA evaluation; 40 healthy women were subjected as control. The specificity and sensitivity of HPV16E6m RNA and CK19m RNA as diagnostic indexes were analyzed; their correlations to clinicopathologic features were investigated. Results The specificity of HPV16E6m RNA and CK19m RNA in the diagnosis of cervical cancer were 97.5%. The sensitivity of HPV16E6m RNA and CK19m RNA in the diagnosis of pre treatment were 15% and 39%, respectively and the difference was statistically significant （P〈0.05）. HPV16E6m RNA elevation was associated with clinical stage （P= 0.012） and pelvic lymph node metastasis （P=0.026）. CK19m RNA was associated with deep muscular invasion （P=0.031） and pelvic lymph node metastasis （P=0.027）. Conclusion Peripheral blood HPV16E6m RNA and CK19m RNA are the valuable tumor markers of cervical cancer. The value of CK19mRNA in the diagnosis of cervical cancer is better than that of HPV16E6m RNA.