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HPV E6/E7 mRNA检测对ASCUS患者临床分层处理价值评价
朱远航;任琛琛;张小安;崔世红;杨立;刘灵
0
(郑州大学第三附属医院)
摘要:
目的:探讨HPV E6/E7 mRNA检测在意义不明确的不典型鳞状细胞(ASCUS)人群进一步处理措施中的分层管理价值。方法:对112例ASCUS患者,同时行HPV E6/E7 mRNA、HPV DNA检测以及阴道镜下活检。结果:(1)ASCUS患者宫颈活检结果分布于宫颈炎及宫颈上皮内瘤变(CIN)Ⅰ、Ⅱ、Ⅲ病变中。(2)HPV E6/E7 mRNA检测ASCUS中高级别病变的敏感性(94.44%)与HPV DNA检测相比差异无统计学意义(P>0.05)。而特异性(45.74%)高于HPV DNA检测(18.89%),差异有统计学意义(P<0.05)。(3)随着宫颈病变级别升高,HPV E6/E7 mRNA载量增加,且各级别病变间差异有统计学意义(P<0.0083); HPV DNA载量在各级别病变中的差异无统计学意义(P>0.0083)。(4)ROC曲线确定的HPV E6/E7 mRNA诊断高级别宫颈上皮内瘤变(CINⅡ~+)的最佳诊断临界点为543.64 copy/ml,曲线下面积为0.780。结论:ASCUS病理结果具有多样性,HPV E6/E7mRNA检测不仅可以检出其中的高级别宫颈病变,减少了不必要的阴道镜检查及活检,还能及时发现潜在高级别宫颈病变,避免高危患者漏诊。
关键词:  意义不明确的不典型鳞状细胞  E6/E7 mRNA  宫颈病变  人乳头瘤病毒
DOI:
基金项目:河南省教育厅资助项目(编号:161100311100)
The Layered Management Value Evaluation of HPV E6/E7 mRNA Test in Women with Atypical Squamous Cell of Undetermined Significance
()
Abstract:
Objective:To explore the layered management value of the further method dealt with in ASCUS(atypical squamous cells undetermined significance) of HPV E6/E7 mRNA Detection.Methods:112 cases who suffered from ASCUS were underwent HPV DNA test,HPV E6/E7 mRNA test,colposcopy and biopsy.Results:(1)The biopsy results of 112 cases of ASCUS contained cervicitis,CINⅠ,CINⅡ,and CIN Ⅲ.(2)There was no significant difference on the sensitivity for detecting high-level lesions between HPV E6/E7 mRNA(94.44%) and HPV E6/E7 mRNA(P>0.05).However,the specificity of HPV E6/E7 mRNA(45.74%) was significantly higher than that of HPV E6/E7 mRNA(18.89%,P<0.05).(3)The HPV E6/E7 mRNA loads increased significantly by the increasing of the level of cervical lesions(P<0.0083);there was no significant difference on the HPV DNA loads among different level of cervical lesions(P>0.0083).(4)The CINⅡ+best diagnostic critical point was 543.64 copies/ml,which was established by receiver operating characteristic(ROC) curve,and the area under the curve was 0.780.Conclusions:Among ASCUS,the pathological diagnosis were diverse,HPV E6/E7 mRNA test can detect most high-level lesions,reduced unnecessary colposcopy and biopsy,and can timely find these patients with high-level lesions potentially and avoid misdiagnosis of high risk cases
Key words:  Atypicalsquamouscellsundeterminedsignificance  E6/E7mRNA  Cervicallesion  Humanpapillomavirus  

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