摘要
目的探讨HPV E6/E7 mRNA联合TCT检测在宫颈癌筛查中的应用价值,为临床合理运用筛查方法提供参考依据。方法选取当地宫颈癌筛查中的高危HPV阳性病例为研究对象,以病理结果为金标准,对HPV E6/E7 mRNA和TCT检测结果进行回顾性分析。结果326例研究对象中,E6/E7检测阳性171例,TCT检查阳性148例,组织病理学诊断为LSIL的261例,HSIL的65例。LSIL组中E6/E7阳性率为45.98%、TCT阳性率为40.23%、联合检测阳性率为68.58%;HSIL组中E6/E7阳性率为78.46%、TCT阳性率为66.15%、联合检测阳性率为92.31%,二组间的3种阳性率差异均有统计学意义(χ2值分别为22.019、14.109、14.972,P=0.000)。E6/E7与TCT方法的检测结果一致性较差(Kappa=0.2986,P=0.000);E6/E7的总阳性率高于TCT,二者差异有统计学意义(χ^2=4.209,P<0.05)。E6/E7法的灵敏度为78.45%、阴性预测值为90.97%,均高于TCT法的66.15%和87.64%,二者特异度和阳性预测值基本相近;将E6/E7+TCT进行联合检测,其灵敏度与阴性预测值则提高到92.31%和94.25%。结论检测E6/E7有助于预测HPV持续感染导致宫颈癌病变进展的风险,有利于HPV阳性病例的分流;E6/E7联合TCT检测,可有效降低阴道镜转诊率,提高宫颈癌筛查的有效性。
Objective To explore the application value of HPV E6/E7 mRNA combined with TCT in cervical cancer screening,and to provide reference for rational use of screening methods in clinic.Methods The high-risk HPV positive cases in the local cervical cancer screening were selected as the research objects,and the pathological results were used as the gold standard to retrospectively analyze the HPV E6/E7 mRNA and TCT test results.Results Of 326 subjects,171 were E6/E7 positive,148 were TCT positive,261 were LSIL and 65 were HSIL.The positive rate of E6/E7 in LSIL group was 45.98%,the positive rate of TCT was 40.23%,and the positive rate of combined detection was 68.58%.The positive rate of E6/E7 in HSIL group was 78.46%,the positive rate of TCT was 66.15%,and the positive rate of combined detection was 92.31%.There was statistical significance on the differences in the three positive rates between the two groups(χ2=22.019,χ2=14.109,χ2=14.972,P=0.000).The consistency between E6/E7 and TCT was poor(Kappa=0.2986,P=0.000);the total positive rate of E6/E7 was higher than that of TCT,and the difference was statistically significant(χ2=4.209,P=0.040).The sensitivity of E6/E7 method was 78.45%,the negative predictive value was 90.97%,higher than that of TCT method(66.15%and 87.64%),while the specificity and positive predictive value of the two methods were basically similar.The sensitivity and negative predictive value of E6/E7+TCT combined detection increased to 92.31%and 94.25%.Conclusion E6/E7 combined with TCT detection is more conducive to the diversion of HPV positive cases in cervical cancer screening,effectively reducing the referral rate of colposcopy and improving the effectiveness of cervical cancer screening.
作者
舒小芳
蔡婷英
施敏伟
樊锦霞
朱文英
卢晓谧
SHU Xiao-fang;CAI Ting-ying;SHI Min-wei;FAN Jin-xia;ZHU Wen-ying;LU Xiao-mi(Jinyun Maternal and Child Health and Family Planning Service Center,Lishui,Zhejiang 321400,China)
出处
《中国卫生检验杂志》
CAS
2020年第8期991-993,996,共4页
Chinese Journal of Health Laboratory Technology
作者简介
舒小芳(1962-),女,中专,副主任医师,主要从事妇产科工作。
