人类白细胞抗原E联合高危型人乳头瘤病毒检测在高级别鱗状上皮内病变和宫颈鳞癌中的诊断价值

Diagnostic Value of Combined Detection of Human Leukocyte Antigen(HLA-E)and High-risk Human Papillomavirus in High-grade Squamous Intraepithelial Lesions and Cervical Squamous Cell Carcinoma

【目的】探讨人类白细胞抗原E(HLA-E)与高危型人乳头瘤病毒(HR-HPV)联合检测在高级别鳞状上皮内病变(HSIL)、宫颈鳞状细胞癌中诊断价值。【方法】选取湖北省松滋市人民医院2017年1月至2019年4月经病理证实的低级别鱗状上皮内病变(LSIL,LSIL组)、HSIL(HSIL组)、宫颈鳞癌(宫颈鳞癌组)患者各40例,选取同期收治的40例慢性宫颈炎患者作为对照组,患者均接受HR-HPV以及液基细胞学检查(TCT)。采用免疫组织化学法检测HLA-E表达情况,比较HLA-E联合HR-HPV与TCT联合HR-HPV在HSIL、宫颈鳞癌中诊断价值。【结果】宫颈鱗癌组HLA-E表达阳性率显著高于HSIL组、LSIL组、对照组(P<0.05),HSIL组HLA-E表达阳性率高于LSIL组、对照组(P<0.05),但LSIL组和对照组HLA-E表达阳性率差异无统计学意义(P>0.05)。宫颈鱗癌组、HSIL组HR-HPV阳性率高于LSIL组、对照组(P<0.05),LSIL组HR-HPV阳性率高于对照组(P<0.05),宫颈鳞癌组、HSIL组HR-HPV阳性率比较差异无统计学意义(P>0.05)。TCT诊断慢性宫颈炎、LSIUHSIL及宫颈鳞癌的准确率分别为35.0%、42.5%、40.0%、52.5%。R()C曲线结果显示:TCT联合HR-HPV与HLA-E联合HR-HPV的ROC曲线下面积(AUC)、灵敏度、特异度比较差异无统计学意义(P>0.05)。【结论】HLA-E在HSIL和宫颈鳞癌中高表达.HLA-E联合HR-HPV诊断HSIL和宫颈鳞癌的价值较高,与TCT联合HR-HPV相当。

【Objective]To investigate the diagnostic value of combined detection of human leukocyte antigen E(HLA-E)and high-risk human papillomavirus(HR-HPV)in high-grade squamous intraepithelial lesion(HSIL)and cervical squamous cell carcinoma.【Methods】Forty patients with low-grade squamous intraepithelial lesions(LSILf LSIL group),40 patients with HSIL(HSIL group),and 40 patients with cervical squamous cell carcinoma(cervical squamous cell carcinoma group)were selected from January I,2017 to April 30,2019 in our hospital.Forty patients with chronic cervicitis who were treated at the same time were selected as the control group.All patients received HR-HPV and liquid-based cytology(TCT).The expression of HLA-E was detected by immuno-histochemistry.The diagnostic value of HLA-E combined with HR-HPV and TCT combined with HR-HPV in HSIL and cervical squamous cell carcinoma were observed.【Results】The positive rate of HLA-K expression in cervical squamous cell carcinoma was higher than that in the HSIL group,the LSIL group and the control group(P<0.05).The positive rate of HLA-E expression in the HSIL group was higher than that in the LSIL group and the control group(P<0.05).There was no significant difference in the positive rate of HLA-E expression between the control group and the control group(P>0.05).The positive rate of HR-HPV in the cervical squa mous cell carcinoma and HSIL group was higher than that in the LSIL group and the control group(P<0.05).The positive rate of the HR-HPV in the LSIL group was higher than that in the control group(P<C0.05).There was no significant difference in the positive rate of HR HPV between the cervical squamous cell carcinoma group)and the HSIL group(P>0.05).The accuracy of TCT in the diagnosis of chronic cervicitis,LSIL.HSIL.and cervical squamous cell carcinoma was 35.0%,42.5%,40.0%,and 52.5%,respectively.The ROC curve showed that the AUC of HLA-E combined with HR-HPV in the diagn ovSis of HSIL and cervical squamous cell carcinoma was 0.737,and the specificity was 68.1%and 70.8%.There was no significant difference in AUC between TCT combined with HR-HPV and HLA-E combined with HR-HPV(P〉0.05).【Conclusion】HLA-E is highly expressed in HSIL and cervical squamous cell carcinoma.HLA-E combined with HR-HPV is of high value in the diagnosis of HSIL and cervical squamous cell carcinoma,which is equivalent to TCT combined with HR-HPV.