| 摘要: |
| 目的探讨人乳头瘤病毒（HPV）E6/E7mRNA检测在宫颈锥切术后宫颈残端不能明确意义的非典型鳞状上皮细胞（ASC-US）患者分流中的诊断价值。方法对160例宫颈锥切术后随访中液基细胞学检查（TCT）诊断为ASC-US患者行HPVE6/E7mRNA和高危型HPV（HR-HPV）DNA检测，结合阴道镜检查、宫颈活检结果，以病理学结果为“金标准”，与HR-HPVDNA检测相比较，评价HPVE6/E7mRNA检测对宫颈锥切术后ASC-US患者分流诊断的价值。结果HPVE6/E7mRNA检测阳性率低于HR-HPVDNA检测阳性率(P＜0.01)。宫颈上皮内瘤变(CIN)II+级和CINIII+级者HPVE6/E7mRNA检测阳性率分别高于CINII-级和CINIII-级者(均P＜0.05)。HPVE6/E7mRNA检测的灵敏度、特异度、阳性预测值、阴性预测值和诊断正确率分别为0.80、0.90、0.79、0.91和86.9%；HR-HPVDNA检测的灵敏度、特异度、阳性预测值、阴性预测值及诊断正确率分别为0.82、0.49、0.43、0.85和59.4%。HPVE6/E7mRNA检测的特异度、阳性预测值和诊断正确率均高于HR-HPVDNA检测（均P＜0.05）。宫颈病变级别高的患者HPVE6/E7mRNA拷贝数明显增加，两者呈正相关（r=0.658，P＜0.01）。结论HPVE6/E7mRNA检测对宫颈锥切术后ASC-US患者的残留/复发具有重要预测价值，可作为术后ASC-US患者分流的有效指标。 |
| 关键词: 人乳头状瘤病毒 HPV E6/E7 mRNA 不能明确意义的非典型鳞状上皮细胞 宫颈锥切术 |
| DOI：10.12056/j.issn.1006-2785.2018.40.7.2017-2818 |
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| Diagnostic value of HPV E6/E7 mRNA in triage of patients with ASC-US after cervical conization |
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Jinhua Municipal Central Hospital
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| Abstract: |
| Objective To assess the diagnostic value of human papilloma virus (HPV) E6/E7 mRNA test in triage of patients with atypical squamous cell of undetermined significance (ASC-US) after cervical conization. Methods A total of 160 patients after cervical conization with ASC-US cytology underwent colposcopic examination and cervical biopsy,and HPV E6/E7
mRNA and high-risk HPV DNA (HR-HPV DNA) tests were performed．With pathological results as the gold standard, the
diagnostic value of HPV E6/E7 mRNA in patients with ASC-US after cervix conization was analyzed and compared with HR-HPV DNA. Results The overall positive rate of HPV E6/E7 mRNA was lower than that of HR-HPV DNA (P＜0.01). The positive rate of HPV E6/E7 mRNA for cervical intraepithelial neoplasia II+ (CIN II+) and CIN Ⅲ+ were higher than that of CIN Ⅱ- and CIN Ⅲ-. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of HPV E6/E7 mRNA in diagnosis of high grades cervical intraepithelial neoplasia (CIN II+ and CIN Ⅲ+ ) were 0.80, 0.90, 0.79, 0.91 and 86.9% , respectively; while those indicators of HR-HPV DNA were 0.82, 0.49, 0.43, 0.85 and 59.4%, The specificity, positive predictive value and accuracy of HPV E6/E7 mRNA weve higher than those of HR-HPV DNA (all P＜0.05). The results also demonstrated that the HPV E6/E7 mRNA
copies were positively correlated with histological severity (r=0.658,P＜0.01). Conclusion The detection of HPV E6/E7 mRNA is of value in predicting the residual/recurrence of ASC-US after cervix conization, indicating that it might be a promising technique in triage of patients with ASC-US after cervical conization. |
| Key words: Human papilloma virus HPV E6/E7 mRNA Atypical squamous cell of undetermined significance Cervi-
cal conization |
