人乳头瘤病毒E6/E7 mRNA检测的临床应用

doi:10.3969/j.issn.1673-8640.2018.07.015

摘要/Abstract

摘要：

目的评价人乳头瘤病毒（HPV）E6/E7 mRNA检测在临床HPV感染筛查中的适用性。方法选取妇科患者5 308例,进行液基薄层细胞学（TCT）检测,同时进行HPV DNA（4 062例）或HPV E6/E7 mRNA（1 246例）检测。根据TCT检测结果将患者分为正常组、意义不明的不典型鳞状细胞（ASCUS）组、低度鳞状上皮内病变（LSIL）组和高度鳞状上皮内病变（HSIL）组,比较各组的检测结果。结果 HPV DNA初筛阳性率[17.67%（718/4 062）]明显高于HPV E6/E7 mRNA[12.12%（151/1 246）]（P<0.05）。HSIL组、LSIL组及ASCUS组HPV DNA阳性率与HPV E6/E7 mRNA阳性率比较,差异均无统计学意义（P>0.05）;正常组HPV DNA阳性率（15.07%）明显高于HPV E6/E7 mRNA阳性率（8.90%）（P<0.05）。HPV DNA阳性者中各组比例与HPV E6/E7 mRNA阳性者各组比例比较,差异有统计学意义（P<0.05）。以LSIL和HSIL为细胞病理学阳性,以正常和ASCUS为细胞病理学阴性。HPV E6/E7 mRNA阳性者中细胞病理学阳性患者的比例[15.23%（23/151）]明显高于HPV DNA阳性者中细胞病理学阳性患者的比例[8.64%（62/718）]（P<0.05）。HPV DNA和HPV E6/E7 mRNA 筛查LSIL+HSIL的敏感性分别为83.78%和85.19%,二者差异无统计学意义（P>0.05）;特异性分别为83.55%和89.50%,二者差异有统计学意义（P<0.05）。结论 HPV E6/E7 mRNA可用于检测HPV感染,其筛查LSIL和HSIL的特异性优于HPV DNA,更适合于临床宫颈癌的筛查。

关键词: 人乳头瘤病毒, 液基薄层细胞学, 宫颈癌筛查

Abstract:

Objective To evaluate the applicability of human papillomavirus（HPV） E6/E7 mRNA determination for screening HPV infection. Methods A total of 5 308 women were enrolled. Thinprep cytologic test（TCT）was performed. HPV DNA determination was performed in 4 062 cases,and HPV E6/E7 mRNA determination was performed in 1 246 cases. According to the results of TCT,the women were classified into normal group,atypical squamous cell of undetermined significance （ASCUS）group,low-grade squamous intraepithelial lesion （LSIL）group and high-grade squamous intraepithelial lesion （HSIL）group. Results The positive rate of HPV DNA determination [17.67%（718/4 062）] was higher than that of HPV E6/E7 mRNA determination [12.12%（151/1 246）] （P<0.05）. The positive rates of HPV DNA determination and HPV E6/ E7 mRNA determination had no statistical significance among HSIL,LSIL and ASCUS groups （P>0.05）. The positive rate of HPV DNA determination in normal group was 15.07%,which was higher than that of HPV E6/E7 mRNA determination （8.90%）（P<0.05）. The positive proportions of HPV DNA and HPV E6/E7 determinations in these groups had no statistical significance （P<0.05）. LSIL and HSIL were determined as cytopathological positive,and normal group and ASCUS group were determined as cytopathological negative. The proportions of LSIL and HSIL in the positive cases of HPV E6/E7 mRNA determination [15.23%（23/151）] were higher than those in HPV DNA determination positive cases [8.64%（62/718）]（P<0.05）. There was no statistical significance for sensitivities of LSIL+HSIL screening between HPV DNA determination （83.78%）and HPV E6/E7 mRNA determination （85.19%）（P>0.05）. The specificities were 83.55% and 89.50%,respectively （P<0.05）. Conclusions HPV E6/E7 mRNA determiantion is suitable for screening HPV infection. It is more specific than HPV DNA determination for screening LSIL and HSIL. It is suitable for clinical cervical cancer screening.

Key words: Human papillomavirus, Thinprep cytologic test, Cervical cancer screening

中图分类号:

R446.1

轩乾坤, 郭建, 吴文娟, 李广波. 人乳头瘤病毒E6/E7 mRNA检测的临床应用[J]. 检验医学, 2018, 33(7): 640-643.

XUAN Qiankun, GUO Jian, WU Wenjuan, LI Guangbo. Clinical application of human papillomavirus E6/E7 mRNA determination[J]. Laboratory Medicine, 2018, 33(7): 640-643.

图/表 1

参考文献 14

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组别	例数	HPV DNA		HPV E6/E7 mRNA
组别	例数	检测例数	阳性例数（%）	检测例数	阳性例数（%）
HSIL组	32	23	22（95.65）	9	8（88.89）
LSIL组	69	51	40（78.43）	18	15（83.33）
ASCUS组	231	180	82（45.56）	51	24（47.06）
正常组	4 976	3 808	574（15.07）	1 168	104（8.90）^*
合计	5 308	4 062	718（17.67）	1 246	151（12.12）^*

组别	例数	HPV DNA		HPV E6/E7 mRNA
组别	例数	检测例数	阳性例数（%）	检测例数	阳性例数（%）
HSIL组	32	23	22（95.65）	9	8（88.89）
LSIL组	69	51	40（78.43）	18	15（83.33）
ASCUS组	231	180	82（45.56）	51	24（47.06）
正常组	4 976	3 808	574（15.07）	1 168	104（8.90）^*
合计	5 308	4 062	718（17.67）	1 246	151（12.12）^*

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