高危型HPV E6/E7 mRNA联合液基细胞学检查提高宫颈病变检出率的研究(1)
[摘要] 目的 研究高危型人乳頭瘤病毒(HPV)E6/E7 mRNA联合液基细胞学检查提高宫颈病变检出率的应用价值。 方法 选取2016年1月～2017年12月于延安市人民医院接受宫颈病变检查的249例患者为研究对象，其中宫颈炎症(170例)、宫颈上皮内瘤变Ⅰ(CINⅠ)(32例)、CINⅡ(28例)、CINⅢ(14例)、宫颈癌(5例)。对所有患者均进行高危型HPV E6/E7 mRNA检查、液基细胞学检查以及组织病理活检。并以病理活检结果为金标准，比较不同检查方式的检出率、灵敏度、特异性。 结果 高危型HPV E6/E7 mRNA检查对宫颈炎症、CIN的检出率分别为83.53%、71.62%，均明显高于液基细胞学检查的68.24%、56.76%，又明显低于联合检查的94.71%、90.54%，差异均有统计学意义(P < 0.05)。高危型HPV E6/E7 mRNA检查诊断CINⅠ的检出率为68.75%，明显高于液基细胞学检查的43.75%，又明显低于联合检查的90.63%，差异均有统计学意义(P < 0.05)。高危型HPV E6/E7 mRNA检查与液基细胞学检查诊断癌前病变的灵敏度分别为76.60%、68.09%，均明显低于联合检查的91.49%；高危型HPV E6/E7 mRNA检查诊断癌前病变的特异性为81.19%，明显高于液基细胞学检查的64.36%，又明显低于联合检查的94.06%，差异均有统计学意义(P < 0.05)。 结论 高危型HPV E6/E7 mRNA联合液基细胞学检查可显著提高宫颈病变检出率，具有较高的临床诊断价值，推广应用价值较好。
[关键词] 宫颈病变；高危型人乳头瘤病毒；液基细胞学检查；宫颈上皮内瘤变
[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210(2018)11(b)-0080-04
[Abstract] Objective To study the application value of the high-risk human papillomavirus (HPV) E6/E7 mRNA combined with liquid based cytology in the improvement of detection rate of cervical lesion. Methods From January 2016 to December 2017， 249 patients with cervical lesions in Yan′an People′s Hospital were selected as the subjects. There were 170 cases of cervical inflammation， 32 cases of cervical intraepithelial neoplasia Ⅰ (CIN Ⅰ)， 28 cases of CIN Ⅱ， 14 cases of CIN Ⅲ， 5 cases of cervical cancer. The detection of high-risk HPV E6/E7 mRNA， liquid based cytology and histopathological biopsy were carried among all patients. The detection rate， sensitivity， and specificity of different examination methods were compared with the results of pathological biopsy. Results The detection rate of high risk type HPV E6/E7 mRNA examination in the diagnosis of cervical inflammation， CIN was 83.53%， 71.62%， which was significantly higher than liquid based cytology of 68.24%， 56.76%， and was significantly lower than the joint detection of 94.71% and 90.54% respectively， the differences between groups were statistically significant (P < 0.05). The detection rate of high-risk type HPV E6/E7 mRNA examination in the diagnosis of CIN Ⅰwas 68.75%， which was significantly higher than the liquid based cytology of 43.75%， the joint detection was significantly lower than the 90.63%， the differences between groups were statistically significant (P < 0.05). The sensitivity of the high-risk HPV E6/E7 mRNA examination and the diagnosis of precancerous lesions was 76.60% and 68.09% respectively， which was significantly lower than 91.49% of the joint detection. The specificity of high-risk HPV E6/E7 mRNA in diagnosing precancerous lesions was 81.19%， which was significantly higher than the liquid based cytology of 64.36%， was significantly lower than the joint detection of 94.06%， the differences between groups were statistically significant (P < 0.05). Conclusion The high risk HPV E6/E7 mRNA combined with cytological examination can significantly improve the detection rate of cervical lesions， which has higher clinical diagnostic value， and worth popularizing., 百拇医药(马娜 张艳 乔娜)
[关键词] 宫颈病变；高危型人乳头瘤病毒；液基细胞学检查；宫颈上皮内瘤变
[中图分类号] R737.33 [文献标识码] A [文章编号] 1673-7210(2018)11(b)-0080-04
[Abstract] Objective To study the application value of the high-risk human papillomavirus (HPV) E6/E7 mRNA combined with liquid based cytology in the improvement of detection rate of cervical lesion. Methods From January 2016 to December 2017， 249 patients with cervical lesions in Yan′an People′s Hospital were selected as the subjects. There were 170 cases of cervical inflammation， 32 cases of cervical intraepithelial neoplasia Ⅰ (CIN Ⅰ)， 28 cases of CIN Ⅱ， 14 cases of CIN Ⅲ， 5 cases of cervical cancer. The detection of high-risk HPV E6/E7 mRNA， liquid based cytology and histopathological biopsy were carried among all patients. The detection rate， sensitivity， and specificity of different examination methods were compared with the results of pathological biopsy. Results The detection rate of high risk type HPV E6/E7 mRNA examination in the diagnosis of cervical inflammation， CIN was 83.53%， 71.62%， which was significantly higher than liquid based cytology of 68.24%， 56.76%， and was significantly lower than the joint detection of 94.71% and 90.54% respectively， the differences between groups were statistically significant (P < 0.05). The detection rate of high-risk type HPV E6/E7 mRNA examination in the diagnosis of CIN Ⅰwas 68.75%， which was significantly higher than the liquid based cytology of 43.75%， the joint detection was significantly lower than the 90.63%， the differences between groups were statistically significant (P < 0.05). The sensitivity of the high-risk HPV E6/E7 mRNA examination and the diagnosis of precancerous lesions was 76.60% and 68.09% respectively， which was significantly lower than 91.49% of the joint detection. The specificity of high-risk HPV E6/E7 mRNA in diagnosing precancerous lesions was 81.19%， which was significantly higher than the liquid based cytology of 64.36%， was significantly lower than the joint detection of 94.06%， the differences between groups were statistically significant (P < 0.05). Conclusion The high risk HPV E6/E7 mRNA combined with cytological examination can significantly improve the detection rate of cervical lesions， which has higher clinical diagnostic value， and worth popularizing., 百拇医药(马娜 张艳 乔娜)