液基细胞学联合 HPV mRNA 检测对宫颈癌的诊断价值 |
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引用本文: | 张博,张颖,牛力春,王建.液基细胞学联合 HPV mRNA 检测对宫颈癌的诊断价值[J].现代肿瘤医学,2016(1):118-122. |
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作者姓名: | 张博 张颖 牛力春 王建 |
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作者单位: | 1. 渭南市中心医院妇产科,陕西 渭南,714000;2. 解放军第三二三医院妇产科,陕西 西安,710054;3. 第四军医大学西京医院妇产科,陕西 西安,710032 |
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基金项目: | 国家自然科学基金,陕西省自然科学基金,解放军第323医院培育课题 |
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摘 要: | 目的:探索高危型 HPV E6/E7 mRNA 和 HPV E6/E7 DNA 两种检测方法分别联合宫颈薄层液基细胞学检查(TCT)应用于宫颈癌早期诊断的临床意义。方法:选择2013年1月至2014年12月我院妇科门诊就诊行 TCT 检查的259例检测标本,对高危型 HPV E6/E7 mRNA 和 HPV E6/E7 DNA 进行检测,结合 xb 细胞病理学分级和组织病理学诊断进行统计分析。结果:纳入研究的259例患者中 HPV E6/E7 mRNA 检测阳性率为35.1%(91/259),HPV E6/E7 DNA 检测阳性率为52.1%(135/259)。NILM、ASCUS、LSIL、HSIL 四种细胞病理学分级 HPV E6/E7 mRNA 和 HPV E6/E7 DNA 检出率分别为23.5%、29.4%、64.3%、66.7%和32.4%、52.5%、61.9%、83.3%。对于正常组织,HPV E6/E7 mRNA 的敏感度、准确度和阳性预测值均低于HPV E6/E7 DNA(P <0.05),但特异度和阴性预测值高于 HPV E6/E7 DNA(P <0.001)。对于 CIN1组织, HPV E6/E7 mRNA 的敏感度、特异度和阳性预测值均低于 HPV E6/E7 DNA(P <0.05),但准确度和阴性预测值高于 HPV E6/E7 DNA(P <0.001)。在 CIN2和 CIN3组织中,HPV E6/E7 mRNA 的准确度和阴性预测值均高于 HPV E6/E7 DNA(P <0.001),HPV E6/E7 mRNA 的敏感度、特异度、阳性预测值与 HPV E6/E7 DNA 无统计学差异(P >0.05)。结论:高危型 HPV E6/E7 mRNA 检测能更准确地反映病毒感染后的活化状态,HPV宫颈薄层液基细胞学检查联合高危型 HPV E6/E7 mRNA 检测可提高宫颈癌早期筛查的准确性。
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关 键 词: | HPVE6/E7mRNA HPVE6/E7DNA 宫颈薄层液基细胞学检查 宫颈癌 |
Clinical value of combination of HPV E6/E7 mRNA assay and thinprep cytologic test as-say in screening of cervical cancer |
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Abstract: | Objective:To assess the clinical value of combination of HPV E6 /E7 mRNA assay and thinprep cyto-logic test assay in screening of cervical cancer.Methods:Exfoliative cervical cells samples were collected from 259 women which carried cervical cancer screening by liquid based thinprep cytology test (TCT).Both the HPV E6 /E7 mRNA assay and the HPV E6 /E7 DNA assay were examined at the same time.The HPV E6 /E7 mRNA assay were performed by branch -DNA (bDNA)technology.The HPV E6 /E7 DNA assay were detected by HibriMax HPV -DNA genotyping.The data according to cytological pathology and histological pathology were analyzed.Results:The positive rates of HPV E6 /E7 mRNA and HPV E6 /E7 DNA were 34.7% (90 /259)and 52.1% (135 /259).The HPV E6 /E7 mRNA positive rates for NILM,ASCUS,LSIL,HSIL were 23.5%,29.4%,64.3%,66.7% respectively, and the HPV E6 /E7 DNA positive rates for NILM,ASCUS,LSIL,HSIL were 32.4%,52.5%,61.9%,83.3% re-spectively.In normal cervical tissues,the sensitivity,accuracy,positive predictive value of HPV E6 /E7 mRNA were lower than the ones of HPV E6 /E7 DNA (P <0.05),and specificity,negative predictive value of HPV E6 /E7 mRNA was higher than the ones of HPV E6 /E7 DNA (P <0.001).In CIN1 tissues,the sensitivity,specificity and positive predictive value of HPV E6 /E7 mRNA were lower than the ones of HPV E6 /E7 DNA (P <0.05),and accuracy,neg-ative predicative value of HPV E6 /E7 mRNA were higher than HPV E6 /E7 DNA (P <0.001).In CIN2 and CIN3 tissues,the accuracy,negative predicative value of HPV E6 /E7 mRNA were higher than the ones of HPV E6 /E7 DNA (P <0.001).While there was no difference between the sensitivity,specificity,positive predicative value of HPV E6 /E7 mRNA and the ones of HPV E6 /E7 DNA (P >0.05).Conclusion:The HPV E6 /E7 mRNA assay can reflect the HPV infections leading to cellular transformation.The combination of the HPV E6 /E7 mRNA assay and thinprep cyto-logic test assay is more specific than HPV E6 /E7 DNA in triage of women in detection of cervical cancer. |
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Keywords: | HPVE6/E7mRNA HPVE6/E7DNA thinprep cytologic test assay cervical cancer |
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