摘要
目的探讨HPV E6/E7 mRNA和DNA分型两种HPV核酸检测方法在宫颈病变中的诊断价值。方法回顾性分析2016年3月至2018年3月在空军军医大学第一附属医院就诊的疑似宫颈病变转阴道镜活检的916例病例。以活检结果为金标准,916例病例共分为5组:宫颈炎症239例,CIN1342例,CIN291例,CIN3183例,宫颈癌61例。比较分析HPV E6/E7 mRNA和HPV DNA分型两种基因检测方法对宫颈病变的检出能力。分析HPV E6/E7 mRNA拷贝数与宫颈病变严重度的关系。结果HPV E6/E7 mRNA和HPV DNA分型检测在宫颈炎症组阳性率分别为19.2%和82.4%,在CIN3组阳性率分别为89.6%和77.1%,宫颈癌组阳性率分别为100%和88.5%,上述差异均有统计学意义(P<0.05)。两种检测方法对高级别宫颈上皮内病变(≥CIN2)的灵敏度分别为90.4%和80.6%,特异度为48.7%和18.9%,阳性预测值为50.4%和36.4%,阴性预测值为89.9%和62.9%,ROC曲线下面积为0.809和0.542。不同宫颈病变程度患者中,HPV E6/E7 mRNA拷贝数随着宫颈病变级别的加重而增加,差异有统计学意义。结论在高级别宫颈上皮内病变中,HPV E6/E7 mRNA的临床诊断价值高于HPV DNA分型检测。此外,HPV E6/E7 mRNA检测可以显著降低炎症患者行阴道镜活检的转诊率,是更有效的宫颈病变基因筛查方法。
Objective To explore the diagnostic value of human papillomavirus(HPV)E6/E7 mRNA and HPV DNA genotyping tests in clinical cervical disease screening.Methods A retrospective analysis was conducted on 916 suspected cervical lesion cases transferred to colposcopy biopsy from March 2016 to March 2018 in the First Affiliated Hospital of Air Force Medical University(Xijing Hospital).With biopsy pathological diagnosis as the gold standard,916 cases were divided into 5 groups:329 cases of cervical inflammation,342 cases of CIN1,91 cases of CIN2,183 cases of CIN3 and 61 cases of cervical cancer.The detection efficiency of HPV E6/E7 mRNA and HPV DNA genotyping tests was analyzed and compared on all cases.And the relationship between HPV E6/E7 mRNA copy number and pathological grades was analyzed.Results The positive rates of HPV E6/E7 mRNA test and HPV DNA genotyping test were 19.2%and 82.4%in cervicitis group,89.6%and 77.1%in CIN3 group,and 100%and 88.5%in cervical cancer group,respectively,and there was statistically significant difference in the positive rates of the two tests in all the groups mentioned above(P<0.05).The sensitivity of HPV E6/E7 mRNA test and HPV DNA genotyping test for high-grade cervical intraepithelial lesion(≥CIN2)was 90.4%and 80.6%,respectively,the specificity of HPV E6/E7 mRNA and DNA genotyping tests was 48.7%and 18.9%,the positive predictive value was 50.4%and 36.4%,the negative predictive value was 89.9%and 62.9%,the area of recei-ver operating characteristic curve was 0.809 and 0.542,respectively.And HPV E6/E7 mRNA copy numbers were significantly increased with the aggravation of pathological grades.Conclusion The diagnostic value of HPV E6/E7 mRNA test is higher than that of HPV DNA genotyping test for high-grade cervical lesions.And HPV E6/E7 mRNA test could reduce the referral rate of inflammatory patients undergoing colposcopy biopsy,and is also of great significance in predicting the severity of cervical lesions.Thus,HPV E6/E7 mRNA is the more recommended gene screening method in clinical.
作者
林晓红
陈柳
高亚娟
燕凤
李佳
杨红
LIN Xiaohong;CHEN Liu;GAO Yajuan;YAN Feng;LI Jia;YANG Hong(Department of Obstetrics and Gynecology,First Affiliated Hospital of Air Force Medical University,Xi’an 710032,China)
出处
《山西医科大学学报》
CAS
2020年第8期865-869,共5页
Journal of Shanxi Medical University
基金
陕西省科技厅社会发展科技攻关项目(2016SF-254)
陕西省科技厅高校联合项目(2020GXLH-Y-009)。
作者简介
林晓红,女,1988-03生,硕士,研究实习员,E-mail:812074064@qq.com;通讯作者:杨红,E-mail:yanghongfck@163.com。
