摘要
目的:比较高危型人乳头瘤病毒(HR-HPV)E6/E7 mRNA与HR-HPV DNA检测在宫颈病变筛查中的诊断性能。探讨其在宫颈细胞学ASCUS/LSIL/ASC-H分流中的意义。方法:收集2016年5月至11月就诊于清华长庚医院妇科的液基细胞学结果为ASCUS、LSIL、ASC-H的患者251例,分别行宫颈脱落细胞HR-HPV DNA、HR-HPV E6/E7mRNA检测,并行阴道镜检查及宫颈活体组织检查,以组织学病理为金标准。结果:HRHPV E6/E7 mRNA阳性率在ASCUS、LSIL和ASC-H中分别为18.34%(20/108)、28.82%(30/102)和39.51%(17/41)。宫颈活检病理结果子宫颈低级别病变(湿疣/CIN1组)与高级别病变(CIN2/3)组的HR-HPV E6/E7 mRNA阳性率比较,差异有统计学意义(P=0.0125)。以子宫颈活检的组织学诊断结果为金标准,HR-HPV E6/E7 mRNA筛查子宫颈高级别病变的特异性及阳性预测值均明显高于HPV-DNA。ASCUS/LSIL/ASC-H中,HRHPV E6/E7 mRNA检测筛查宫颈高级别病变的ROC曲线面积均大于HPV-DNA,诊断效能优于HPV-DNA。结论:HPV E6/E7 mRNA检测诊断宫颈高级别病变的特异性及阳性预测值高于HPV-DNA,能辅助宫颈细胞学筛查及HPV-DNA,提高宫颈高级别病变诊断的特异性,在细胞学检查阶段对患者做出有效分流,预测宫颈高级别病变。
Objective：To compare the difference of HR-HPV E6/E7 mRNA and HRHPV DNA in cervical cancer screening.To investigate the application value of human papillomavirus E6/E7 mRNA in the cytological screening ASCUS/LSIL/ASC-H.Methods：251 cases who suffering from ASCUS/LSIL/ASC-H in TCT were collected from Department of Gynecology outpatient in Beijing Tsinghua Changgung Hospital from May.2016 to Nov.2016.HR-HPV E6/E7 mRNA and HPV-DNA detection were performed on the cervical cells.The result was compared with the pathological result of colposcopebiopsy.Results：The positive rates of HR-HPV E6/E7 mRNA in ASCUS,LSIL and ASC-H were 18.34%（20/108）,28.82%（30/102） and 39.51%（17/41）,respectively.Cervical exfoliated cells HR-HPV E6/E7 mRNA expression rate difference was statistically significant（P=0.012 5） between cervical low-grade lesions（wet wart/CIN1 group） and high level lesions（Cin2/3 group）,The specificity and positive predictive value of HR-HPV E6/E7 mRNA detection and diagnosis were higher than that of HPV-DNA,and the ROC curve areas of HR-HPV E6/E7 mRNA were bigger than HPV-DNA in ASCUS/LSIL/ASC-H.Conclusion： The specificity and positive predictive value of HR-HPV E6/E7 mRNA in the diagnosis of cervical high grade lesion was higher than HR-HPV detection.HR-HPV E6/E7 mRNA could assist cervical cytology screening and HPV-DNA to improve the specificity of the diagnosis of high-grade cervical lesions,and make effective triage in the cytology stage to predict the possibility of high-grade cervical lesions.
作者
吕涛
吴忧
廖秦平
张蕾
Lü Tao Wu You Liao Qinping et al.(Beijing Tsinghua Changgung Hospital,School of Clinical Medicine, Tsinghua University, Beijing 102218 Department of Gynecology, Cancer Hospital Chinese Academy of Medical Sciences,Beijing 100020)
出处
《现代妇产科进展》
CSCD
北大核心
2017年第9期670-673,共4页
Progress in Obstetrics and Gynecology
基金
北京市医院管理局临床医学发展专项经费资助(No:XMLX201605)
国家自然科学基金(No:81671409)
