宫颈脱落细胞miR—125b与宫颈病变关系及其在HR—HPV阳性患者分层筛查中的作用研究(1)
摘 要：目的 比較正常宫颈、宫颈上皮内瘤变及宫颈癌患者宫颈脱落细胞中miR-125b表达水平差异，探讨宫颈脱落细胞miR-125b表达水平检测在HR-HPV阳性患者分层筛查中的作用及其与宫颈病变的关系。方法 采用第二代杂交捕获技术进行HR-HPV初筛，HR-HPV阳性患者行宫颈液基薄层细胞学检查及miR-125b检测。液基细胞学检查结果异常者直接阴道镜下活检行病理学检查，液基细胞学检查正常者行阴道镜检查，阴道镜检查下发现异常者行阴道镜下活检取材，余视作宫颈组织学正常，不做宫颈活检。RT-qPCR检测正常宫颈及不同级别宫颈病变中miR-125b表达水平，比较不同组织学分组之间的宫颈脱落细胞miR-125b表达水平，绘制ROC曲线，探讨miR-125b、液基细胞学检查在宫颈病变中的诊断作用。结果 宫颈脱落细胞miR-125b水平随着宫颈病变程度加重逐渐升高(P<0.05)；在HR-HPV阳性患者分层筛查中，宫颈液基细胞学诊断宫颈高级别上皮内病变的敏感性、特异性分别为64.90%、80.70%，AUC为0.728(95%CI：0.657～0.779，P<0.001)。与液基细胞学检查相比，宫颈脱落细胞miR-125b检测诊断宫颈高级别上皮内病变的灵敏性、特异性更高(87.30% vs 64.90%；69.20% vs 80.70%)，AUC为 0.864(95%CI：0.800～0.928，P<0.001)。结论 miR-125b水平随着宫颈病变加重逐渐升高，检测宫颈脱落细胞miR-125b水平可有效分流HR-HPV阳性患者，敏感性高于细胞学检查，可能成为一种有效的分层筛查方法。
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关键词：宫颈病变；miR-125b；HR-HPV；宫颈癌筛查
中图分类号：RR737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.021
文章编号：1006-1959(2018)23-0076-04
Abstract：Objective To compare the expression levels of miR-125b in cervical exfoliated cells of normal cervix， cervical intraepithelial neoplasia and cervical cancer， and to explore the role of miR-125b expression in cervical exfoliated cells in stratified screening of HR-HPV positive patients. The relationship between cervical lesions. Methods The second-generation hybridization capture technique was used for HR-HPV screening. The HR-HPV-positive patients underwent cervical-based thin-layer cytology and miRNA125b detection. The results of liquid-based cytology were abnormal. The pathological examination was performed directly under biopsy. The liquid-based cytology was performed by colposcopy. The abnormalities were found under colposcopy. The colposcopy biopsy was performed. Normal， no cervical biopsy. RT-qPCR was used to detect the expression of miR-125b in normal cervical and different grades of cervical lesions. The expression levels of miR-125b in cervical exfoliated cells were compared between different histological groups. ROC curves were drawn to investigate miR-125b and liquid-based cytology. The role of diagnosis in cervical lesions. Results The level of miR-125b in cervical exfoliated cells increased with the severity of cervical lesions (P<0.05). In the stratified screening of HR-HPV positive patients， the sensitivity of cervical liquid-based cytology in the diagnosis of high-grade intraepithelial lesions of the cervix， The specificities were 64.90% and 80.70%， respectively， and the AUC was 0.728 (95% CI： 0.657～0.779，P<0.001). Compared with liquid-based cytology， the sensitivity and specificity of cervical exfoliated cells miR-125b for the diagnosis of high-grade intraepithelial lesions of the cervix were higher (87.30% vs 64.90%； 69.20% vs 80.70%)， and the AUC was 0.864 (95%CI： 0.800～0.928，P<0.001). Conclusion The level of miR-125b is gradually increased with the increase of cervical lesions. The detection of miR-125b in cervical exfoliated cells can effectively divert HR-HPV positive patients， which is more sensitive than cytology and may be an effective stratified screening method., 百拇医药(NEELAMSAH 聂小凤 张琴)
, http://www.100md.com
关键词：宫颈病变；miR-125b；HR-HPV；宫颈癌筛查
中图分类号：RR737.33 文献标识码：A DOI：10.3969/j.issn.1006-1959.2018.23.021
文章编号：1006-1959(2018)23-0076-04
Abstract：Objective To compare the expression levels of miR-125b in cervical exfoliated cells of normal cervix， cervical intraepithelial neoplasia and cervical cancer， and to explore the role of miR-125b expression in cervical exfoliated cells in stratified screening of HR-HPV positive patients. The relationship between cervical lesions. Methods The second-generation hybridization capture technique was used for HR-HPV screening. The HR-HPV-positive patients underwent cervical-based thin-layer cytology and miRNA125b detection. The results of liquid-based cytology were abnormal. The pathological examination was performed directly under biopsy. The liquid-based cytology was performed by colposcopy. The abnormalities were found under colposcopy. The colposcopy biopsy was performed. Normal， no cervical biopsy. RT-qPCR was used to detect the expression of miR-125b in normal cervical and different grades of cervical lesions. The expression levels of miR-125b in cervical exfoliated cells were compared between different histological groups. ROC curves were drawn to investigate miR-125b and liquid-based cytology. The role of diagnosis in cervical lesions. Results The level of miR-125b in cervical exfoliated cells increased with the severity of cervical lesions (P<0.05). In the stratified screening of HR-HPV positive patients， the sensitivity of cervical liquid-based cytology in the diagnosis of high-grade intraepithelial lesions of the cervix， The specificities were 64.90% and 80.70%， respectively， and the AUC was 0.728 (95% CI： 0.657～0.779，P<0.001). Compared with liquid-based cytology， the sensitivity and specificity of cervical exfoliated cells miR-125b for the diagnosis of high-grade intraepithelial lesions of the cervix were higher (87.30% vs 64.90%； 69.20% vs 80.70%)， and the AUC was 0.864 (95%CI： 0.800～0.928，P<0.001). Conclusion The level of miR-125b is gradually increased with the increase of cervical lesions. The detection of miR-125b in cervical exfoliated cells can effectively divert HR-HPV positive patients， which is more sensitive than cytology and may be an effective stratified screening method., 百拇医药(NEELAMSAH 聂小凤 张琴)