HR-HPVE6／E7mRNA联合TCT检查在宫颈病变筛查中的应用

目的探讨高危型人乳头瘤病毒（HR—HPV）E6／E7mRNA联合液基细胞学检查（TCT）在宫颈病变筛查中的应用价值。方法分析430例因宫颈疾病就诊患者的TCT、HR—HPVE6／E7mRNA、HR—HPvDNA检查结果。结果HR—HPVE6／E7mRNA检出率为33．49％。HR—HPVDNA检出率为49．30％，随着病理级别的升高，HR—HPvE6／E7mRNA和HR-HPVDNA阳性率均呈现趋势性升高。在炎症组HR—HPVDNAF~性率显著高于HR—HPVE6／E7mRNA（P〈0．05），在CINI＋患者组HR—HPVDNA敏感性略高于HR—HPVE6／E7mRNA。但HR—HPVE6／E7mRNA特异度和阳性预测值显著高于HR—HPVDNA（P〈0．05）。结论HR—HPVE6／E7mRNA联合TCT检测与病理检查的阳性符合率明显高于单纯TCT检测的阳性率，从而明显提高宫颈癌前病变和宫颈癌的检出率。

Objective To explore the application value of the combination detection. HR-HPV E6/E7 mRNA and TCT cytology in the screening of the uterine cervical lesions. Methods Exfohative cervical cells samples were collected from 430 women which carried by hquid based thinprep cytology test （ TCT ） , both the HR-HPV E6/E7 mRNA assay and the HR-HPV DNA assay were examined at the same time.The data according to histological pathology were analyzed. Results The positive rate of HR-HPV E6/ETmRNA and HR-HPV DNA test was 33.49% and 49.30%, respectively. The HR-HPV E6/E7mRNA and HR-HPV DNA positive rate was increased along with the increase of the grade of cervical lesions. The positive rate of HR-HPV DNA was significantly higher in inflammation group than that of HR-HPV E6/E7 mRNA （ P〈0.05 ） .The sensitivity of HR-HPV DNA in CIN I ＋ was shghdy higher than that of HR-HPV E6/ETmRNA. But the specific degree and positivepredictive value of HR-HPV E6/E7 mRNA was significantly higher than that of HR-HPV DNA （ P〈0.05 ） . Conclusions The positive coincidence rate between the positive histopathology and the positive HR-HPVE6/E7mRNA with abnormal TCT cytology is evidently higher than that between the positive histopathology and singly positive TCT cytology. Thus, the combination of I-IR-HPVE6/ETmRNA detection and TCT cytology can significantly improve the detection rate of the precancerous lesions and carcinomas in the uterine cervix.