宫颈E6／E7 mRNA联合TCT检查在一般妇女宫颈病变早期筛查中的应用

目的 探讨宫颈E6/E7 mRNA联合TCT检查在一般妇女宫颈病变早期筛查中的意义。 方法 选择2015年4月-2016年12月同时行HPV E6/E7 mRNA及宫颈薄层液基细胞学检查(TCT)的中年一般妇女为研究对象共360例进行宫颈癌和癌前病变筛查,以组织学检查作为金标准,评价二者联合检测效果。 结果 CIN组HPV E6/E7 mRNA检测阳性率(86.18%)明显高于慢性炎症组(29.33%)(χ2=114.074,P<0.05),CIN1、CIN2、CIN3及宫颈癌患者中,HPV E6/E7 mRNA检测结果阳性率分别为79.59%、86.84%、88.46%、100.00%,阳性率随宫颈病变严重程度呈上升趋势;CIN组TCT细胞学检测阳性率(68.42%)明显高于慢性炎症组(22.12%)(χ2=77.476,P<0.05),TCT细胞学对CIN1、CIN2、CIN3及宫颈癌患者的检测阳性率分别为57.14%、68.42%、76.92%、76.92%,阳性率随宫颈病变严重程度呈上升趋势;HPV E6/E7 mRNA检测结果阳性率为54.17%,TCT细胞学检测阳性率为38.89%,二者具有一致性(r=0.428,P<0.05);E6/E7 mRNA联合TCT检测诊断符合率为80.83%,高于TCT单独检测(P>0.05)。 结论 E6/E7 mRNA联合TCT细胞学检测可以提高一般妇女宫颈癌前病变筛查的诊断效率,是一种无创性检查,值得在宫颈癌前病变筛查中推广应用。 

Application of HPV E6/E7 mRNA test combined with Thinprep cytologic test in early screening of cervical lesions

Objective To investigate the significance of HPV E6/E7 mRNA test combined with Thinprep cytologic test (TCT) in the early screening of cervical lesions in rural middle-aged women. Methods The early screening for cervical cancer and precancerous lesions by using HPV E6/E7 mRNA test and TCT was performed in 360 rural middle-aged women in our hospital between April, 2015 and December, 2016, in which the histological examination was used as the gold standard to evaluate the effect of the combined test. Results The positive rate of HPV E6/E7 mRNA in CIN group was 86.18%, which was significantly higher than that of chronic inflammation group (29.33%), χ2=114.074, P<0.05. The positive rate of HPV E6/E7 mRNA for CIN1, CIN2, CIN3 and patients with cervical cancer were 79.59%, 86.84%, 88.46% and 100.00%, respectively, which showed an increased trend. The positive rate by TCT test in CIN group was 68.42, which was significantly higher than that of chronic inflammation group (22.12%), χ2=77.476, P<0.05. The positive rate by TCT test in CIN1, CIN2, CIN3 and cervical cancer was 57.14%, 68.42%, 76.92% and 76.92%, respectively, which showed an increased trend. The mean test positive rate of HPV E6/E7 mRNA (54.17%) and TCT (38.89%) had consistency (r=0.428, P<0.05). The sensitivity and negative predictive value of HPV E6/E7 mRNA test combined with TCT were significantly higher than the result by one of them (P<0.05). There was no significant difference in the specificity and positive predictive value among the three methods (P>0.05). The diagnostic accuracy of the combined test was 80.83%, which was higher than that by TCT test. Conclusion E6/E7 mRNA test combined with TCT can improve diagnostic efficiency, and advantage of noninvasive test. It is worthy of popularization and application in the screening of precancerous cervical lesions.