HR-HPV E6/E7 mRNA联合TCT检查在宫颈病变筛查中的应用

摘要

目的 探讨高危型人乳头瘤病毒(HR-HPV)E6/E7 mRNA联合液基细胞学检查(TCT)在宫颈病变筛查中的应用价值.方法 分析430例因宫颈疾病就诊患者的TCT、HR-HPV E6/E7mRNA、HR-HPV DNA检查结果.结果 HR-HPV E6/E7 mRNA检出率为33.49％,HR-HPV DNA检出率为49.30％,随着病理级别的升高,HR-HPV E6/E7mRNA和HR-HPV DNA阳性率均呈现趋势性升高.在炎症组HR-HPV DNA阳性率显著高于HR-HPV E6/E7mRNA(P<0.05),在CINⅠ+患者组HR-HPV DNA敏感性略高于HR-HPV E6/E7mRNA,但HR-HPV E6/E7mRNA特异度和阳性预测值显著高于HR-HPV DNA(P<0.05).结论 HR-HPV E6/E7 mRNA联合TCT检测与病理检查的阳性符合率明显高于单纯TCT检测的阳性率,从而明显提高宫颈癌前病变和宫颈癌的检出率.%Objective To explore the application value of the combination detection. HR-HPV E6/E7 mRNA and TCT cytology in the screening of the uterine cervical lesions. Methods Exfoliative cervical cells samples were collected from 430 women which carried by liquid based thinprep cytology test(TCT),both the HR-HPV E6/E7 mRNA assay and the HR-HPV DNA assay were examined at the same time.The data according to histological pathology were analyzed. Results The positive rate of HR-HPV E6/E7mRNA and HR-HPV DNA test was 33.49％ and 49.30％,respectively. The HR-HPV E6/E7mRNA and HR-HPV DNA positive rate was increased along with the increase of the grade of cervical lesions. The positive rate of HR-HPV DNA was significantly higher in inflammation group than that of HR-HPV E6/E7 mRNA(P<0.05).The sensitivity of HR-HPV DNA in CINⅠ+ was slightly higher than that of HR-HPV E6/E7mRNA. But the specific degree and positivepredictive value of HR-HPV E6/E7 mRNA was significantly higher than that of HR-HPV DNA(P<0.05). Conclusions The positive coincidence rate between the positive histopathology and the positive HR-HPVE6/E7mRNA with abnormal TCT cytology is evidently higher than that between the positive histopathology and singly positive TCT cytology. Thus,the combination of HR-HPVE6/E7mRNA detection and TCT cytology can significantly improve the detection rate of the precancerous lesions and carcinomas in the uterine cervix.