摘要
目的探讨HPV E6/E7 m RA在宫颈癌和癌前病变(CINⅠ、CINⅡ及CINⅢ)组织中的表达及意义。方法以该院2012-2016年收治的年龄30~65岁,阴道镜活体组织检查(活检)病理为CINⅠ、CINⅡ、CINⅢ及宫颈癌共200例为研究对象,分别行HPV-DNA及HPV E6/E7 m RNA检查,并比较HPV-DNA和HPV E6/E7 m RNA对CINⅡ、CINⅢ及宫颈癌病变诊断评估。结果 85例CINⅠ、65例CINⅡ、40例CINⅢ、10例宫颈癌HPV E6/E7 m RNA、HPV-DNA检测阳性率对比分别是36.47%对61.18%、55.38%对73.85%、70.00%对77.50%及100.00%对100.00%。随宫颈癌前病变级别的升高直至宫颈癌两种方法检测HPV感染率呈显著增加的趋势,CINⅠ、CINⅡ、CINⅢ级及宫颈癌之间相互比较,差异有统计学意义(χ~2=22.93,9.04,均P<0.05)。HPV E6/E7 m RNA、HPV-DNA对115例CINⅡ、CINⅢ及宫颈癌敏感性、特异性、阳性预测值、阴性预测值对比分别是65.80%对72.74%、80.93%对54.35%、62.53%对39.44%、85.38%对84.45%。两组比较敏感性及阴性预值,差异无统计学意义(均P>0.05);特异性及阳性预测值,差异有统计学意义(均P<0.05)。结论随宫颈癌前病变级别的升高直至宫颈癌HPV E6/E7 m RNA表达呈显著增加的趋势,HPV E6/E7 m RNA及HPV-DNA仍是目前宫颈疾病筛查较好的方法,但是HPV E6/E7 m RNA有较好的特异性及阳性预测值,可能更适用于宫颈癌及高级别宫颈癌前病变发病风险评估。
Objective To explore the expression and significance of HPV E6/E7 mRNA in cervical cancer and cervical precancerous lesion [cervical intraepithelial neoplasia （CIN） Ⅰ,CIN Ⅱ,CINⅢ] tissues.Methods A total of 200 patients aged 30-65 years old who were diagnosed as CIN Ⅰ,CIN Ⅱ,CIN Ⅲ,and cervical cancer by colposcopic biopsy and pathological examination in Huaian Municipal Maternal and Child Health Care Hospital from 2012 to 2016 were selected,HPV-DNA detection and HPV E6/E7 mRNA detection were performed.The value of HPV-DNA detection and HPV E6/E7 mRNA detection in diagnosis of CIN Ⅱ,CIN Ⅲ,and cervical cancer was compared.Results Among 200 patients,85 patients with CIN Ⅰ,65 patients with CIN Ⅱ,40 patients with CIN Ⅲ,and 10 patients with cervical cancer were included.The positive detection rates of HPV E6/E7 mRNA and HPV-DNA were 36.47% vs.61.18%,55.38% vs.73.85%,70.00% vs.77.50%,100.00% vs.100.00%,respectively.HPV infection rates of the two methods increased significantly with the aggravation of cervical lesions from cervical precancerous lesion to cervical cancer.There were statistically significant differences among different cervical lesions （x2 =22.93,9.04,P〈0.05）.Among 115 patients with CIN Ⅱ,CINⅢ,and cervical cancer,the sensitivities,specificities,positive predictive values,and negative predictive values of HPV E6/E7 mRNA detection and HPV-DNA detection were 65.80% vs.72.74%,80.93% vs.54.35%,62.53% vs.39.44%,85.38% vs.84.45%,respectively.There was no statistically significant difference in sensitivity and negative predictive value between the two groups （P〉0.05）,while there were statistically significant differences in specificity and positive predictive value between the two groups （P〈0.05）.Conclusion The expression of HPV E6/E7 mRNA increases significantly with the aggravation of cervical lesions from cervical precancerous lesion to cervical cancer.HPV E6/E7 mRNA detection and HPV-DNA detection are still good methods to screen cervical diseases,HPV E6/E7 mRNA detection has good specificity and positive predictive value,which may be more suitable for risk evaluation of cervical cancer and high-grade cervical precancerous lesions.
作者
靳立功
袁智民
项媛媛
吴萍
JIN Li-Gong;YUAN Zhi-Min;XIANG Yuan-Yuan;et al(Department of Gynecology, Huaian Municipal Maternal and Child Health Care Hospital, Huaian, Jiangsu 223002, Chin)
出处
《中国妇幼保健》
CAS
2017年第24期6284-6286,共3页
Maternal and Child Health Care of China
基金
淮安市科技局立项(HAS2013031)
关键词
宫颈上皮内瘤样病变
宫颈癌
Cervical intraepithelial neoplasia
Cervical cancer
HPV E6/E7 mRNA
HPV-DNA
