| 人乳头瘤病毒E6/E7mRNA检测在宫颈病变中的诊断价值研究 |
| 投稿时间：2017-11-23 修订日期：2017-12-04 点此下载全文 |
| 引用本文：苏瑛,谢婷婷,于月成.人乳头瘤病毒E6/E7mRNA检测在宫颈病变中的诊断价值研究[J].医学研究杂志,2018,47(11):137-141 |
| DOI：
10.11969/j.issn.1673-548X.2018.11.030 |
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| 中文摘要: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10月在笔者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活检的女性病例262例，活检同期均行HPV E6/E7mRNA检测，以宫颈组织病理活检为标准对照。对比3种方法检测宫颈病变HSIL的敏感度、特异性、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），及3种方法在不同病理级别中的检出情况，并分析HPV E6/E7mRNA病毒载量与病变关系。结果 HPV E6/E7mRNA检测宫颈病变≥HSIL的敏感度与HPV DNA基因分型和细胞学相似，特异性、阳性预测值、阴性预测值、阳性似然比均高于细胞学和HPV DNA基因分型；HPV E6/E7mRNA的受试者工作特征曲线下面积（AUC=0.80， P<0.01）高于细胞学（AUC=0.65， P<0.01）和HPV DNA分型（AUC=0.54，P>0.05）的曲线下面积；HPV mRNA和细胞学在不同病理级别中的检出率比较，差异有统计学意义（P<0.01），HPV DNA基因分型在不同病理级别中的检出率比较差异无统计学意义（P>0.05）；HPV E6/E7 mRNA表达水平与组织病理分级之间的相关关系有统计学意义（P<0.01），且HPV E6/E7mRNA表达水平与宫颈病理分级间呈正相关（r=0.467）。结论 HPV E6/E7mRNA检测对宫颈病变诊断准确性优于细胞学和HPV DNA分型，在宫颈病变及癌变的筛查中具有一定的临床价值，临床医生应给予关注。 |
| 中文关键词:HPV E6/E7 mRNA 细胞学 HPV DNA分型 宫颈病变 |
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| Diagnostic Value of Human Papillomavirus E6/E7mRNA Test in Cervical Lesions |
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| Abstract:Objective To evaluate the clinical value of HPV E6/E7 mRNA in cervical lesions screening. Methods We collected 163 women who condected the cervical cancer co-screening of cytology test+HPV DNA genotyping and finally conducted colposcopy and biopsy. Meanwhile everyone had done HPV E6/E7 mRNA.The pathological results were used as gold standard. We compared the diagnostic indexes to evaluate each method for high grade cervical lessions and the relationship between HPV mRNA expression level and pathological grades.As well as detection rate of each screening. Results The sensitivity of HPVE6/E7 mRNA,HPV DNA genotyping and cytology test in detection cervical lesions ≥HSIL were similar,and the specificity,positive predictive value,negative predictive value and poitive likelihood value for sreening CIN2+were higher than HPV DNA genotyping and cytology test. The area under the receiver operator charactreistic cure of HPV E6/E7mRNA (AUC=0.80,P<0.01)were higher than HPV DNA genotyping (AUC=0.54,P>0.05)and cytology (AUC=0.65,P<0.01).In different pathologies the detection rate of HPV mRNA and cytology were siginificantly different (P<0.01),but there was no significant difference in the detection rate of HPV DNA genotyping (P>0.05).HPV E6/E7 in different pathological grades mRNA expression levels were statistically significant (P<0.01).And HPV mRNA copy value were positively correlated to cerical lesions (r=0.467). Conclusion HPV E6/E7 mRNA has higher diagnostic accuracy in cervical lesions than the other two.Its has huge clinical value in screening for cervical lesions and cancer.We should give it attention. |
| keywords:HPV E6/E7 mRNA Cytology HPV DNA genotyping Cervical lesion |
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