高危型HPVE6/E7 mRNA检测在HPV DNA阳性患者中的临床意义

Clinical significance of high-risk HPV E6/E7 mRNA test in patients with HPV infection

目的:探讨高危型人乳头状瘤病毒(high risk human papilloma virus,HR-HPV)E6/E7 mRNA检测在HPV病毒感染患者中的临床价值和意义。方法:选取2017年1—6月在宫颈疾病诊治中心进行宫颈机会性筛查,且HPV DNA检测阳性病例200例,分别行HPVE6/E7 mRNA检测和阴道镜下的宫颈活组织检查,分析病毒阳性患者中E6/E7 mRNA的检出率以及不同病理诊断中E6/E7 mRNA的表达情况。结果:200例HPV DNA阳性患者中,HPVE6/E7 m RNA检出率为60.0%。病理学诊断高度鳞状上皮内病变(HSIL)以上,E6/E7 mRNA阳性表达最高,与正常组或低度鳞状上皮内病变(LSIL)组均有明显差异,并且E6/E7 m RNA检测的敏感度和阴性预测值较高,分别为97.9%和98.8%(P <0.05)。病理学诊断≤LSIL,E6/E7 mRNA阳性率较低,敏感度、特异度、阳性预测值和阴性预测值都不高。结论:HPVE6/E7 mRNA基因检测可用于HPV DNA阳性患者的分流,避免过度治疗,减轻患者心理负担。HPVE6/E7 mRNA阳性表达在宫颈筛查中对高级别病变的诊断具有临床价值。

Objective：To investigate the clinical value and significance of high risk human papilloma virus（HPV）E6/E7 mRNA test in patients with HPV infection. Methods：Between January 2017 and June 2017,in Center of Diagnosis and Treatment for Cervical Disease,200 patients with HPV infection in cervical screening received high-risk HPV E6/E7 mRNA test and pathological biopsy under colposcopy. We analyzed the E6/E7 mRNA detection rate of positive cases,and the E6/E7 mRNA expression in different pathological diagnosis. Results：The E6/E7 mRNA detection rate was 60% in the 200 patients. The highest E6/E7 m RNA positive expression in the high-grade squamous intraepithelial lesion group（HSIL）had significant differences with the low-grade squamous intraepithelial lesion group（LSIL）and the nomal group. The m RNA sensitivity was 97.9% and negative predictive value was 98.8%（P〈0.05）. The sensitivity,specificity,positive predictive value and negative predictive value were lower in the LSIL group.Conclusion：We could shunt the patients with HPV infection,avoid excessive treatment and reduce the patient＇s psychological burden byHR-HPV E6/E7 mRNA test. High-risk HPV E6/E7 m RNA test has high clinical value in diagnosis of HSIL during cervical screening.