核酸分子杂交-流式细胞术检测HPV E6/E7 mRNA初步研究

Preliminary research for the determination of HPV E6/E7 mRNA by nucleic acid molecular hybridization-flow cytometry

目的探讨核酸分子杂交-流式细胞术检测HPV E6/E7 mRNA的可靠性和应用价值。方法收集2018年10月—2019年10月广东省妇幼保健院和中山大学附属第一医院妇科普通门诊常规宫颈癌筛查结果异常的361例已婚女性患者的子宫颈上皮脱落细胞样本,并进行新柏氏液基细胞学检测(TCT)、HPV DNA检测、HPV E6/E7 mRNA检测和组织病理学检查。结果HPV E6/E7 mRNA检测阳性率随组织病理学检查结果严重级别的升高而增加。与HPV DNA比较,HPV E6/E7 mRNA有较高的特异性(72.73%)和阳性预测值(47.06%)。当TCT结果为ASCUS时,依据HPV E6/E7 mRNA结果进行阴道镜检分流的正确率为66%。结论HPV E6/E7 mRNA检测与组织病理学检查有较高的一致性,且阴道镜镜检分流正确率和判断子宫颈组织高度病变的特异性、阳性预测值均较高。

Objective To investigate the reliability and application value of determining human papillomavirus(HPV)E6/E7 mRNA by nucleic acid molecular hybridization-flow cytometry.Methods Totally,361 samples of cervical epithelial exfoliated cells collected from gynecological departments of Guangdong Maternal and Child Health Hospital and the First Affiliated Hospital of Sun Yat-sen University from October 2018 to October 2019 were collected,and thinprep cytologic test(TCT),HPV DNA,biopsy histopathology and HPV E6/E7 mRNA determinations were performed.Results The proportion of positive HPV E6/E7 mRNA results was increased with the severity of pathological biopsy results.Compared with HPV DNA,HPV E6/E7 mRNA had higher specificity(72.73%)and positive predictive value(47.06%).According to HPV E6/E7 mRNA results,the accuracy of colposcopy shunt of atypical squamous cell of undetermined significance(ASCUS)in abnormal TCT results was 66%.Conclusions HPV E6/E7 mRNA has high consistency with histopathological examination,and the accuracy of colposcopy shunt,specificity and positive predictive value for high-grade lesions are high.