HPV E6/E7 mRNA在宫颈癌早期筛查与诊断的应用研究

Study on the application of HPV E6/E7 mRNA for early screening and diagnosis of cervical cancer

目的 采用流式细胞术探讨人乳头瘤病毒E6/E7mRNA对宫颈病变早期筛查与诊断的应用价值。方法选取宫颈上皮瘤变CINⅡ11例,CINⅢ15例,宫颈癌样本18例,以及正常对照样本16例,采用流式细胞术检测HPV E6/E7mRNA的表达情况。结果 CINⅡ组(72.7%,8/11)、CINⅢ组(80%,12/15)和宫颈癌组(88.9%,16/18)的E6/E7mRNA阳性率显著高于正常对照组(18.8%,3/16),其余各组间比较差异无统计学意义;HPV E6/E7mRNA的ROC曲线下的相关区域面积达0.8778(95%CI 0.7932-0.9624);CINⅡ及以上级别宫颈病变的HPV E6/E7mRNA检测灵敏度为81.82%(95%CI 67.29%-91.81%),特异度为81.25%(95%CI 54.35%-95.95%),阳性预测值为92.31%(95%CI 79.13%-98.38%),阴性预测值为61.90%(95%CI 38.44%-81.89%)。结论 HPV E6/E7mRNA可作为宫颈病变的筛查指标,流式细胞术定量检测HPV E6/E7mRNA可以作为宫颈癌早期筛查和诊断的辅助方法。

Objective Exploring the application value of human papillomavirus E6/E7mRNA on early screening and diagnosis of cervical lesions by flow cytometric assay.Methods The samples from 11cases of CIN(cervical intraepithelial neoplasia)Ⅱ,15cases of CIN III,18cases of cervical cancer and 16cases of negative control were collected to detect the expression levels of HPV E6/E7mRNA by flow cytometric assay.Results The positive rate of E6/E7mRNA form CIN Ⅱ(72.7%,8/11),CIN Ⅲ(80%,12/15),cervical cancer(88.9%,16/18)was higher than that of normal controls(18.8%,3/16)and there is no statistical significance between the other groups;The area under ROC curve of HPV E6/E7mRNA was 0.8778(95% CI 0.7932-0.9624);The sensitivity of HPV E6/E7mRNA in CIN Ⅱ+ was81.82%(95% CI 67.29%-91.81%)and the specificity was 81.25%(95% CI 54.35%-95.95%);The positive predictive value of HPV E6/E7mRNA in CIN Ⅱ+ was 92.31%(95% CI 79.13%-98.38%)and the negative predictive value was 61.90%(95% CI 38.44%-81.89%).Conclusion HPV E6/E7mRNA can be used as a screening index of cervical lesions and detection of it by flow cytometric assay can be used as an auxiliary method for early screening and diagnosis of cervical cancer.