FRD联合HR-HPV DNA、HPV E6/E7 mRNA检测对宫颈上皮内瘤变的诊断意义

Diagnostic significance of FRD combined with HR-HPV DNA and HPV E6/E7 mRNA detection in cervical intraepithelial neoplasia

目的探讨叶酸受体介导的宫颈特殊染色法(FRD)联合高危人乳头状瘤病毒(HR-HPV)DNA、人乳头状瘤病毒(HPV)E6/E7 mRNA检测对宫颈上皮内瘤变(CIN)的诊断意义。方法以2018年5月至2020年4月佛山市第一人民医院进行诊治的200例CIN患者作为观察组,另选取同期100例健康妇女作为对照组。对所有受试者进行FRD、HR-HPV DNA、HPV E6/E7 mRNA检测,比较2组受试者及不同病理分级CIN患者的检测结果。采用Spearman相关分析CIN诊断、病理分级与FRD、HR-HPV DNA、HPV E6/E7 mRNA检测阳性率的相关性,采用受试者工作特征(ROC)曲线评价FRD、HR-HPV DNA、HPV E6/E7 mRNA单独和联合检测对CIN的诊断效能。结果FRD检测CIN的假阳性率为3.00%,假阴性率为8.00%,2组FRD诊断CIN的准确率差异无统计学意义(P>0.05);CINⅡ级、Ⅲ级患者FRD检测的阳性率均高于CINⅠ级(P<0.05)。2组HR-HPV DNA、HPV E6/E7 mRNA检测诊断CIN准确率比较,差异均有统计学意义(P<0.05);CINⅡ级、Ⅲ级患者HR-HPV DNA、HPV E6/E7 mRNA检测的阳性率均高于CINⅠ级(P<0.05)。CIN诊断、病理分级与FRD、HR-HPV DNA、HPV E6/E7 mRNA检测的阳性率均呈正相关(r>0,P<0.05)。FRD、HR-HPVDNA、HPVE6/E7mRNA联合检测诊断CIN的曲线下面积(AUC)、灵敏度和特异度均明显高于单独检测诊断的AUC、灵敏度和特异度(P<0.05)。结论FRD、HR-HPV DNA、HPV E6/E7 mRNA联合检测对CIN具有较高的诊断效能,值得临床推广。

Objective To investigate the diagnostic significance of folate receptor-mediated tumor detection(FRD)combined with high-risk human papillomavirus(HR-HPV)DNA and human papillomavirus(HPV)E6/E7 mRNA in cervical intraepithelial neoplasia(CIN).Methods A total of 200 patients with CIN treated in the First People′s Hospital of Foshan from May 2018 to April 2020 were selected as the observation group,and 100 healthy women in the same period were selected as the control group.FRD,HR-HPV DNA and HPV E6/E7 mRNA were detected in all subjects,and the detection results of the two groups of subjects and CIN patients with different pathological stages were compared.Spearman correlation was used to analyze the correlation between the diagnosis and pathological stage of CIN and the positive rates of FRD,HR-HPV DNA and HPV E6/E7 mRNA.The diagnostic efficacy of FRD,HR-HPV DNA and HPV E6/E7 mRNA alone and in combination for CIN was measured by receiver operating characteristic(ROC)curve.Results The false positive rate of FRD for CIN detection was 3.00%,and the false negative rate was 8.00%.There was no statistical signifcance in the accuracy difference of the two groups of FRD for CIN diagnosis(P>0.05).The positive rate of FRD in patients with CINⅡandⅢwas higher than that of CINⅠ(P<0.05).Comparison of the accuracy of HR-HPV DNA and HPV E6/E7 mRNA in the diagnosis of CIN between the two groups,the differences were statistically significant(P<0.05).The positive rates of HR-HPV DNA and HPV E6/E7 mRNA in patients with CINⅡandⅢwere higher than those in CINⅠ(P<0.05).The diagnosis and pathological stage of CIN were positively correlated with the positive rates of FRD,HR-HPV DNA and HPV E6/E7 mRNA(r>0,P<0.05).The area under the curve(AUC),sensitivity and specificity of the combined detection of FRD,HR-HPV DNA and HPV E6/E7 mRNA in the diagnosis of CIN were significantly higher than the AUC,sensitivity and specificity of the single diagnosis(P<0.05).Conclusion The combined detection of FRD,HR-HPV DNA and HPV E6/E7 mRNA has a high diagnostic efficiency for CIN and is worthy of clinical promotion.