摘要
目的:探索高危型HPV E6/E7 mRNA和HPV E6/E7 DNA两种检测方法分别联合宫颈薄层液基细胞学检查(TCT)应用于宫颈癌早期诊断的临床意义。方法:选择2013年1月至2014年12月我院妇科门诊就诊行TCT检查的259例检测标本,对高危型HPV E6/E7 mRNA和HPV E6/E7 DNA进行检测,结合xb细胞病理学分级和组织病理学诊断进行统计分析。结果:纳入研究的259例患者中HPV E6/E7 mRNA检测阳性率为35.1%(91/259),HPV E6/E7 DNA检测阳性率为52.1%(135/259)。NILM、ASCUS、LSIL、HSIL四种细胞病理学分级HPV E6/E7 mRNA和HPV E6/E7 DNA检出率分别为23.5%、29.4%、64.3%、66.7%和32.4%、52.5%、61.9%、83.3%。对于正常组织,HPV E6/E7 mRNA的敏感度、准确度和阳性预测值均低于HPV E6/E7 DNA(P<0.05),但特异度和阴性预测值高于HPV E6/E7 DNA(P<0.001)。对于CIN1组织,HPV E6/E7 mRNA的敏感度、特异度和阳性预测值均低于HPV E6/E7 DNA(P<0.05),但准确度和阴性预测值高于HPV E6/E7 DNA(P<0.001)。在CIN2和CIN3组织中,HPV E6/E7 mRNA的准确度和阴性预测值均高于HPV E6/E7 DNA(P<0.001),HPV E6/E7 mRNA的敏感度、特异度、阳性预测值与HPV E6/E7 DNA无统计学差异(P>0.05)。结论:高危型HPV E6/E7 mRNA检测能更准确地反映病毒感染后的活化状态,HPV宫颈薄层液基细胞学检查联合高危型HPV E6/E7 mRNA检测可提高宫颈癌早期筛查的准确性。
Objective：To assess the clinical value of combination of HPV E6/E7 mRNA assay and thinprep cytologic test assay in screening of cervical cancer. Methods： Exfoliative cervical cells samples were collected from 259 women which carried cervical cancer screening by liquid based thinprep cytology test （TCT）. Both the HPV E6/E7 mRNA assay and the HPV E6/E7 DNA assay were examined at the same time. The HPV E6/E7 mRNA assay were performed by branch - DNA （bDNA） technology. The HPV E6/E7 DNA assay were detected by HibriMax HPV - DNA genotyping. The data according to cytological pathology and histological pathology were analyzed. Results： The positive rates of HPV E6/E7 mRNA and HPV E6/E7 DNA were 34.7% （90/259） and 52.1% （135/259）. The HPV E6/E7 mRNA positive rates for NILM, ASCUS, LSIL, HSIL were 23.5% ,29.4% ,64.3% ,66.7% respectively, and the HPV E6/E7 DNA positive rates for NILM, ASCUS, LSIL, HSIL were 32.4% ,52.5% ,61.9% ,83.3% respectively. In normal cervical tissues, the sensitivity, accuracy, positive predictive value of HPV E6/E7 mRNA were lower than the ones of HPV E6/E7 DNA （ P 〈 0.05 ）, and specificity, negative predictive value of HPV E6/E7 mRNA was higher than the ones of HPV E6/E7 DNA （ P 〈 0. 001 ）. In CIN1 tissues, the sensitivity, specificity and positive predictive value of HPV E6/E7 mRNA were lower than the ones of HPV E6/E7 DNA （ P 〈 0. 05 ） , and accuracy, negative predicative value of HPV E6/E7 mRNA were higher than HPV E6/E7 DNA （ P 〈 0.001 ）. In CIN2 and CIN3 tissues, the accuracy, negative predicative value of HPV E6/E7 mRNA were higher than the ones of HPV E6/E7 DNA （P 〈 0.001 ）. While there was no difference between the sensitivity, specificity, positive predicative value of HPV E6/ E7 mRNA and the ones of HPV E6/E7 DNA （ P 〉 0.05）. Conclusion ： The HPV E6/E7 mRNA assay can reflect the HPV infections leading to cellular transformation. The combination of the HPV E6/E7 mRNA assay and thinprep cytologic test assay is more specific than HPV E6/E7 DNA in triage of women in detection of cervical cancer.
出处
《现代肿瘤医学》
CAS
2016年第1期118-122,共5页
Journal of Modern Oncology
基金
国家自然科学基金项目(编号:81302243
81172458)
陕西省自然科学基金项目(编号:2014JM4157)
解放军第323医院培育课题(编号:2012323B14)
