荧光定量聚合酶链反应在尖锐湿疣诊断中的应用

The Use of FQ-PCR in Detecting Condyloma Acuminata

目的 探讨荧光定量聚合酶链反应 (FQ - PCR)对尖锐湿疣 (CA )的诊断价值。方法 FQ- PCR检测病理确诊的 CA患者 36份标本和健康人 84份标本 ;FQ- PCR及病理诊断同期检测临床送检病例 2 73份标本 ,并做诊断性试验评价。结果 36例病理确诊的 CA患者 HPV6和 HPV11的 DNA FQ- PCR全部阳性 ,平均拷贝数为 1.0× 10 7± 1.0× 10 2 / m l;84例健康人 FQ- PCR全部阴性 ,平均拷贝数为 3× 10± 2× 10 / ml。 FQ- PCR与病理诊断符合率为 10 0 % ,CA患者与健康人拷贝数的差异有显著性 (P<0 .0 5 )。FQ- PCR与病理诊断对比得出 :灵敏度为 10 0 % ,特异度为 92 % ,误诊率为 0 .0 8,漏诊率为 0 ,准确度为 98.9% ,阳性预测值为 98.8% ,阴性预测值为 10 0 % ,阳性似然比为 12 .5 ,阴性似然比为 0。结论 FQ - PCR能准确定量 ,灵敏度高 ,特异性强 ,快速 ,简便 。

Objective To assess the value of flurogenic quantitative polymerase chain reaction (FQ PCR) in detecting condyloma acuminatum(CA). Methods Thirty six samples of CA pathologically diagnosed as positive cases and 84 samples of healthy controls were tested with FQ PCR, and another 273 samples of clinical cases were examined using both pathological method and FQ PCR. Then FQ PCR as a diagnostic test was evaluated. Results FQ PCR detected HPV6, HPV11 DNA in all the 36 CA samples, the mean copy being 1.0×10 7±1.0×10 2/ml; the 84 samples of the healthy group ware all negative, the mean copy being 3×10 1±2×10 1/ml. The coincidence rate of FQ PCR with the pathological diagnosis was 100%. There was significant differnce in copy amount between the CA group and the healthy group,( P <0.05). At the second stage, comparison between FQ PCR and the pathological diagnosis showed: Se was 100%, Sp 92%, α was 0.08, β 0, accuracy was 98.9%, positive predictive value was 98.8%, negative predictive value 100%; positive likelihood ratio was 12.5, and negative likelihood ratio 0. Conclusion FQ PCR as a rapid and simple method could accurately detect and quantify CA and its Se and Sp were high; it can be taken as an index in early CA diagnosis.