| 摘要: |
| 目的评估人乳头瘤病毒（HPV）E6/E7mRNA检测对绝经后妇女中宫颈病变诊断的价值。方法选择行液基细胞学技术（TCT）和高危型HPV（HR-HPV）DNA联合筛查的绝经后妇女1032例，任一结果阳性均行HPVE6/E7mRNA检测及阴道镜活检。以病理诊断为金标准，与TCT及HR-HPVDNA比较，分析HPVE6/E7mRNA检测诊断病理分级HSIL以上（HSIL+）的价值，并比较不同病理分级患者的HPVE6/E7mRNA表达量。结果TCT诊断HSIL+的灵敏度、特异度、阳性预测值、阴性预测值均低于HPVE6/E7mRNA，差异均有统计学意义（均P＜0.05）。HR-HPVDNA诊断HSIL+的灵敏度、阳性预测值、阴性预测值与HPVE6/E7mRNA比较，差异均无统计学意义（均P＞0.05）；而特异度明显低于HPVE6/E7mRNA，差异有统计学意义（P＜0.01）。3种检测方法中HPVE6/E7mRNA的特异度最高。不同病理分级患者HPVE6/E7mRNA表达量差异有统计学意义（P＜0.01）；病理分级与HPVE6/E7mRNA表达量呈正相关（r=0.401，P＜0.01）。结论HPVE6/E7mRNA检测对绝经后妇女宫颈病变的筛查及预测HSIL+的风险有重要的临床价值。 |
| 关键词: HPV E6/E7 mRNA TCT HR-HPV DNA 绝经后妇女 宫颈病变 |
| DOI：10.12056/j.issn.1006-2785.2018.40.7.2017-624 |
| 分类号: |
| 基金项目:衢州市指导性科技项目（2016072） |
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| Diagnostic value of HPV E6/E7 mRNA test for cervical lesions in postmenopausal women |
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Quzhou People's Hospital
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| Abstract: |
| Objective To assess the value of HPV E6/E7 mRNA test for diagnosis of cervical lesions in postmenopausal women. Methods A total of 1 032 postmenopausal women who were screened by Thinprep cytologic test(TCT) and HR-HPV DNA in Quzhou People's Hospital from February 2015 to February 2017 were enrolled. Patients with either positive results were referred to HPV E6/E7 mRNA test and colposcopic examination. With the pathological results as the gold standard, the value of HPV E6/E7 mRNA test in diagnosis of above high-grade squamous intraepithelial lesions (HSIL+) was evaluated and compared with the TCT and HR-HPV DNA test; the expression of HPV E6/E7 mRNA in different cervical lesions was also compared. Results The sensitivity, specificity, positive predictive value and negative predictive value of TCT for diagnosis of HSIL+ were all lower than those
of HPV E6/E7 mRNA(all P＜0.05). There were no statistically significant difference in sensitivity, positive predictive value and negative
predictive value for diagnosis of HSIL+ between HR-HPV DNA and HPV E6/E7 mRNA（all P＞0.05）, but the specificity of HR-HPV DNA was significantly lower than that of HPV E6/E7 mRNA test (P＜0.01). Among three test methods, the specificity of HPV E6/E7 mRNA was the highest. There was significant difference in the expression levels of HPV E6/E7 mRNA among patients with different pathological grades (P＜0.01). A positive correlation was found between the pathological grades and the expression of HPV E6/E7 mRNA(r =0.401, P＜0.01). Conclusion HPV E6/E7 mRNA test is of clinical value in screening cervical cancer and predicting the risk of HSIL+ in postmenopausal women. |
| Key words: HPV E6/E7 mRNA TCT HR-HPV DNA Postmenopausal women Cervical lesions |
