HPV E6/E7 mRNA检测在ASC-US患者分层处理中的应用研究

摘要

目的 探讨HPV E6/E7 mRNA检测在意义不明确的宫颈不典型鳞状上皮细胞(ASC-US)患者分层处理中的应用.方法 对312例薄层液基细胞学检查结果为ASC-US的患者进行HPV E6/E7mRNA检测.结合病理诊断资料,进行统计学分析.结果 312例患者中,上皮细胞正常或炎症样变211例(67.63％),其中HPVE6/E7mRNA阳性率为43.40％(92/211);低度鳞状上皮内病变(LSIL)66例(21.15％),其中HPV E6/E7 mRNA阳性率为71.21％ (47/66);高度鳞状上皮内病变(HSIL)35例(11.22％),其中HPV E6/E7 mRNA阳性率为91.18％ (32/35).HPV E6/E7 mRNA对LSIL/HSIL的诊断敏感性为78.22％,特异性为56.40％,阳性预测值为46.20％,阴性预测值为84.40％.结论 HPV E6/E7 mRNA检测可以应用于ASC-US患者分层处理,避免对宫颈高度病变的漏诊.%Objective To investigate the application of human papilloma virus (HPV) E6/E7 mRNA test to process atypical squamous cells of undetermined significance (ASC-US) in layers.Methods 312 patients with ASC-US underwent HPV E6/E7 mRNA test.The pathology data was statistically analyzed.Results Stratified by pathology,the positive rate of HPV E6/E7 mRNA was 43.40％ in 211 patients (67.63％) with inflammation or normal,71.21％ in 66 patients (21.15％) with LSIL (low-grade squamous intraepithelial lesion) and 91.18％ in 35 patients (11.22％) with HSIL (high-grade squamous intraepithelial lesion).Among the detection efficiency of HPV E6/E7 mRNA test for ISIL/HSIL,the sensitivity was 78.22％,the specificity was 56.40％,positive predictive value (PPV) was 46.20％,and negative predictive value (NPV) was 84.40％.Conclusion HPV E6/E7 mRNA test can be well used in hierarchical processing of ASC-US to avoid the misdiagnosis of high-grade cervical lesion.