HPV病毒E2 mRNA检测在宫颈病变筛查中的临床价值

Clinical value of HPV virus E2 mRNA detection in cervical lesion screening

目的探究人乳头瘤病毒(HPV)E2信使核糖核酸(mRNA)检测在宫颈病变筛查中的临床价值。方法选取2017年2月至2019年1月400例HR-HPV阳性,TCT(液基薄层细胞检测)≤LSIL(低度鳞状上皮内病变)的宫颈脱落细胞标本作为研究对象,均实施RT-PCR检测HPV病毒E2mRNA的不同级别的宫颈病变情况,记录其表达并评价将其应用于筛查宫颈病变的灵敏度、特异度、阳性预测值和阴性预测值。结果宫颈细胞学检查结果显示,正常/炎症患者200例,占50.00%,ASCUS 110例,占27.50%,LSIL 90例,占22.50%;HPV-E2 mRNA在ASCUS患者中的阳性表达率低于正常/炎症患者,LSIL患者阳性表达率低于ASCUS患者,差异有统计学意义(P<0.05)。检测结果显示,随着宫颈病变病情的不断加重HPV病毒E2 mRNA的表达下降,差异有统计学意义(P<0.05)。HPV-E2 mRNA在正常/炎症患者中诊断灵敏度、特异度、阳性预测值及阴性预测值分别为77.2%、96.2%、75.4%、96.0%,在ASCUS中分别为81.5%、91.7%、79.2%、92.5%,在LSIL中分别为95.5%、93.4%、94.7%、95.6%。结论 HPV病毒E2mRNA检测在宫颈病变筛查中的临床价值显著,值得临床推广应用。

Objective To investigate the clinical value of human papillomavirus(HPV)E2 messenger ribonucleic acid(mRNA)detection in cervical lesion screening.Methods 400 HR-HPV-positive,TCT≤LSIL cervical exfoliated cell specimens were collected from February 2017 to January 2019.All of them were subjected to RT-PCR to detect different levels of HPV E2 mRNA in the cervix.For lesions,the expression was recorded and evaluated for sensitivity,specificity,positive predictive value,and negative predictive value for screening for cervical lesions.Results Cervical cytology revealed 200 normal/inflamed patients(50.00%),110 ASCUS patients(27.50%),90 LSIL patients(22.50%),and HPV-E2 mRNA in ASCUS patients.The rate of positive expression was lower in patients with LSIL than in normal/inflamed patients,and the difference was statistically significant(P<0.05).The results showed that the expression of HPV virus E2 mRNA decreased with the increase of cervical lesions,and the correlation was statistically significant(P<0.05).The diagnostic sensitivity,specificity,positive predictive value,and negative predictive value of HPV-E2 mRNA in normal/inflamed patients were 77.2%,96.2%,75.4%,and 96.0%,respectively,in ASCUS 81.5%,91.7%,79.2%,and 92.5%,respectively 95.5%,93.4%,94.7%,and 95.6%in LSIL.Conclusion The clinical value of HPV virus E2 mRNA detection in cervical lesion screening is significant and worthy of clinical application.