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目的通过应用DNA分型、mRNA定量、细胞和组织病理等方法检测宫颈病变患者,探索HPV E6/E7 mRNA定量检测在宫颈病变筛查中的临床价值。方法标本来源于2014年1月至2015年12月在邵逸夫医院妇科门诊就诊的患者。采用b DNA技术对553例患者行HPV E6/E7mRNA检测,同期做HR-HPV DNA分型检测,以宫颈组织病理学诊断作为金标准进行统计分析。结果不同宫颈病变级别中,HPV E6/E7 mRNA的表达量,随宫颈病变程度的加重而增加(P<0.05)。以≥CIN2为研究终点,采用χ2检验,HPV E6/E7mRNA和HRHPV DNA分型检测的特异度分别为45.1%、26.1%(P<0.05),差异有统计学意义。比较两种检测方法的ROC曲线,HPV E6/E7mRNA较HR-HPV DNA分型检测曲线下面积更大。结论宫颈HPV E6/E7 mRNA检测对于高级别宫颈上皮内瘤变的诊断有一定的指导意义。
Objective To investigate the clinical value of quantitative detection of HPV E6 / E7 mRNA in screening cervical lesions by applying DNA typing, mRNA quantification, cell and histopathology to detect cervical lesions. Methods Specimens were collected from gynecological clinics at Run Run Shaw Hospital from January 2014 to December 2015. HPV DNA E6 / E7 mRNA was detected in 553 patients by b DNA technique. HR-HPV DNA typing was performed in the same period. The cervical histopathology was used as the gold standard for statistical analysis. Results The expression of HPV E6 / E7 mRNA increased with the severity of cervical lesions in different cervical lesions (P <0.05). Using χ2 test, the specificity of HPV E6 / E7 mRNA and HRHPV DNA typing in detecting ≥CIN2 was 45.1% and 26.1% respectively (P <0.05), the difference was statistically significant. Comparing the ROC curves of the two detection methods, the area under the curve of HPV E6 / E7 mRNA was greater than that of HR-HPV DNA typing test. Conclusion The detection of HPV E6 / E7 mRNA in cervix is helpful for the diagnosis of high grade cervical intraepithelial neoplasia.