人乳头瘤病毒HPV E6/E7mRNA检测用于宫颈癌术后随访的研究

Human papillomavirus(HPV) HPV E6/E7mRNA detection for cervical cancer postoperative follow-up research

目的探讨运用宫颈脱落细胞检测人乳头瘤病毒HPV E6/E7 m RNA用于宫颈癌患者宫颈癌术后复发风险评估临床应用价值。方法对在我院妇科住院且行宫颈癌手术治疗的120例患者,在手术后3个月内取阴道脱落细胞进行HPV E6/E7 m RNA检测,并于术后6个月、12个月、18个月时进行薄层液基细胞学检测(thin-prep cytology test,TCT)和阴道镜检测,阴道镜检阳性患者作组织病理活检确认,分析HPV E6/E7m RNA检测方法对宫颈癌术后复发风险评估的应用价值。结果术后出现残留/复发患者共21例,其中20例HPV E6/E7检测结果为阳性。HPV E6/E7 m RNA检测针对术后复发风险预测其敏感性为95.23%,特异性为100%,阳性预测值为100%,阴性预测值为99%。结论 HPV E6/E7 m RNA检测方法可作为宫颈癌术后随访患者复发风险评估的有效措施。

Objective To explore the diagnostic value of human papillomavirus E6/E7 m RNA for residue and recurrence of cervical intraepithelial neoplasia(CIN) patients after cervical conization.Methods A total of 154 patients,who underwent cervical conization and possessed complete follow-up data of high-grade cervical intraepithelial neoplasia(CINII,III),were subjected to prep cytology test(TCT) and HPV E6/E7 m RNA test during a 18-month follow-up survey after cervical surgery.Abnormal cytology(≥ASC-US) or HPV E6/E7 m RNA(+) cases were found by colposcopy and cervical biopsy pathological diagnosis.Results 21 patients had residue or recurred lesions after total 18 months follow-up.Among them,20 were found postive by HPV E6/E7 m RNA detections at the beginning of this study.The sensitivity,specificity,positive predictive value,and negative predictive value of diagnosis in the detection of HPV E6/E7 m RNA were 95.23%,100%,100%,99%,and 94.2%,Conclusion Detection of HPV E6/E7 m RNA during the follow-up period could timely and effectively forecast the risk of residue and recurrence of CIN after cervical surgery.