摘要
目的:利用超薄液基细胞学检测标本(LCT)分析高危人乳头瘤病毒(HPV)E6/E7mRNA检测在宫颈癌筛查中的意义。方法:选取231例液基细胞学检测标本,根据病理级别分为炎症/良性组(n=78)、ASCUS组(n=140)、LSIL组(n=8)和HSIL组(n=5)。利用bDNA技术检测细胞学标本中HPV E6/E7mRNA、DNA,结合病理诊断资料,进行统计学分析。结果:对不同细胞学级别中mRNA及DNA检测情况行配对χ2检验显示,炎症/正常细胞组DNA和mR-NA,阳性检出率差异无统计学意义,χ2=2.307,P>0.05;ASCUS组阳性检出率差异有统计学意义,χ2=9.082,P=0.020;LSIL组与HSIL组例数少,阳性检出率差异无统计学意义,P值分别为0.464和0.800。34例行宫颈活检的AS-CUS标本,2种检测指标在检出率差异无统计学意义,P值均>0.05;在进行活检的43例标本中,对不同病理级别HPVE6/E7mRNA及DNA检测情况行配对Fisher精确概率检验,2种检测指标检出率差异无统计学意义,P值均>0.05。分析预测效能,HPV E6/E7mRNA对LSIL/HSIL诊断敏感性为33.33%,95%CI为17.19～54.63;特异性为72.73%,95%CI为51.85～86.85;阳性预测值为53.85%,95%CI为29.14～76.79;阴性预测值为53.33%,95%CI为36.14～69.77。HPV E6/E7mRNA联合细胞学检测诊断敏感性为100%,95%CI为84.54～100.00;阴性预测值为100%,95%CI为43.85～100.00。结论:高危HPV E6/E7mRNA可以应用于宫颈癌筛查,在筛查中联合HPV E6/E7mRNA及细胞学检测有利于提高诊断准确性。
OBJECTIVE：To investigate the role of testing E6/E7 mRNA of high risk human papilloma virus （HPV） directly from liquid-based l：hin layer cytology test （LCT） samples for cervical cancer screening. METttODS： Branched DNA （bDNA） technology was used to detect high risk HPV E6/E7 mRNA and DNA directly from LCT samples. The data according to cytological grades or pathology were statistically analyzed. RESULTS.. We demonstrated the detectable rate of high risk HPV E6/E7 mRNA and high risk HPV E6/E7 DNA in all 5 cytological grades among 231 samples with chi square test. Positive detection rate difference was not significant in inflammation or normal cell group （78 cases, x2 = 2. 307, P〈0.05）. IN ASCUS group（140 cases）, positive detection rate difference was statistically significant （X2 = 9. 082, P=0. 020）. Positive detection rate difference was not significant in LSIL （n= 8） or HSIL （n= 5） group （P value were 0. 464 and 0. 800）. And 34 cases of ASCUS specimens were verified by pathology. The detectable rate of high riskE6/E7 mRNA test was equal to the test of high risk HPV E6/E7 DNA in normal/inflammation or LSIL/HSIL group （P〈0.05）, The detectable rate of high risk HPV E6/E7 mRNA in all pathological grades among 43 samples was almost identical to high risk HPV E6/E7 DNA （P〈0.05）. The sensitivity of high risk HPV E6/E7 mRNA test was 33.33% （95%CI=17. 19--54.63）. The specificity of high risk HPV E6/E7 mRNA test was 72.73%（95%CI=51.85--86.85）, while positive predictive value （PPV） was 53.85%（95CI=29. 14--76.79）,and negative predictive value （NPV） was 53.33（95%CI=36.14--69.77） ,respectively. The high risk HPV E6/E7 mRNA test associated with LCT test may en- hance clinical sensitivity（ 100%, 95% CI = 84. 54 -- 100. 00） and negative predictive value （100M, 95% CI 43.85-- 100.00） in cervical cancer screening. CONCLUSIONS.. The tests of high risk HPV E6/E7 mRNA can be a useful tool for cervical cancer screening. Applying E6/E7 mRNA test combined with LCT may be more effective in screening and follow-up.
出处
《中华肿瘤防治杂志》
CAS
北大核心
2013年第14期1061-1064,共4页
Chinese Journal of Cancer Prevention and Treatment
基金
宁德市科技局立项(20110001)
