HPV E6/E7mRNA在宫颈病变检测中的诊断价值

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摘要目的探索HPV E6/E7mRNA检测在宫颈病变中的诊断价值。方法收集2016年12月—2017年5月在西京医院妇科行细胞学和HPV DNA基因分型联合筛查发现疑似宫颈病变并转阴道镜行组织活检的女性163例,活检同期均行HPV E6/E7mRNA检测,以宫颈组织病理活检结果为标准对照。比较HPV E6/E7mRNA、细胞学、HPV DNA分型三种方法检测CIN II+的灵敏度、特异度、阳性预测值、阴性预测值、阳性似然比、阴性似然比及受试者工作特征曲线下面积(AUC)等指标,及三种方法对各宫颈病变的检出能力,并分析HPV E6/E7mRNA表达水平与病变关系。结果 HPV E6/E7mRNA、HPV DNA基因分型和细胞学检测病变CIN II+的灵敏度分别为86.8%、88.7%、88.7%;特异度为71.8%、19.1%、43.6%;阳性预测值为59.7%、34.6%、43.1%;阴性预测值为91.8%、77.8%、88.8%;阳性似然比为3.1、1.1、1.6;阴性似然比为0.2、0.6、0.3;AUC为0.793、0.539、0.662,HPV E6/E7mRNA诊断准确性优于细胞学和HPV DNA分型;不同病理级别中HPV E6/E7mRNA表达水平差异具有统计学意义(P<0.01),且HPV E6/E7mRNA表达水平与宫颈病变级别呈正相关(P<0.05)。结论 HPV E6/E7mRNA检测对宫颈病变的诊断具有一定的临床指导意义,临床医生应给予关注。

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	苏瑛
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	于月成

关键词 ：宫颈病变, HPV E6/E7 mRNA, 细胞学, HPV DNA 分型

Abstract：Objective To explore the diagnostic value of human papillomavirus (HPV) E6/E7 mRNA in cervical lesions screening.Methods From December 2016 to May 2017 in the department of obstetrics and gynecology of Xijing Hospital, we collected 163 women who were screened for cervical lesion in the combined test of cytology and HPV DNA genotyping, then conducted transvaginal biopsy. Meanwhile all patients were detected through HPV E6/E7 mRNA testing, and the cervical biopsy pathological diagnosis was used as the gold standard. We compared HPV E6/E7 mRNA, cytology, and HPV DNA genotyping to detect CINII+ in the indicators of sensitivity, specificity, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio, and area under the receiver operating characteristic curve (AUC). We also compared the ability of three methods to detect cervical lesion, and the relationship between HPV E6/E7 mRNA expression level and pathological grades.Results The results of indicators of HPV E6/E7 mRNA, HPV DNA genotyping and cytological test for screening cervical lesion CINII+ were as follows: The sensitivities were 86.8%, 88.7% and 88.7%; The specificities were 71.8%, 19.1% and 43.6%; The positive predictive values were 59.7%, 34.6% and 43.1%; The negative predictive values were 91.8 %, 77.8% and 88.8%; The positive likelihood values were 3.1, 1.1 and 1.6; The negative likelihood values were 0.2, 0.6 and 0.3; The AUC were 0.793, 0.539 and 0.662, respectively. Diagnostic performance of HPV E6/E7 mRNA was higher than that of HPV DNA genotyping and cytological test. There was statistical significance between different pathological grades and HPV E6/E7 mRNA expression levels (P<0.01), and HPV E6/E7 mRNA expression levels were positively correlated to cervical lesion grads (P<0.05).Conclusion HPV E6/E7 mRNA has clinical significance for the diagnosis of cervical lesion, and clinicians should pay attention to it.

Key words： cervical lesion HPV E6/E7 mRNA cytology HPV DNA genotyping

收稿日期: 2017-12-04

通讯作者: 于月成(yuyuecheng@126.com)

引用本文:

苏瑛, 范小斌, 罗天爱, 谢婷婷, 于月成. HPV E6/E7mRNA在宫颈病变检测中的诊断价值[J]. 中国生育健康杂志, 2018, 29(6): 506-510.
SU Ying, FAN Xiaobin, LUO Tianai, XIE Tingting, YU Yuecheng. Diagnostic value of human papillomavirus E6/E7 mRNA in the detection of cervical lesions. Chinese Journal of Reproductive Health, 2018, 29(6): 506-510.

链接本文:

http://cjrh.bjmu.edu.cn/CN/ 或 http://cjrh.bjmu.edu.cn/CN/Y2018/V29/I6/506

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