HPV E6/E7 mRNA检查对宫颈细胞学ASCUS的分流价值

目的 探讨人乳头瘤病毒(HPV)E6/E7 mRNA检查在宫颈细胞学检查结果为意义不明确的非典型鳞状上皮细胞(ASCUS)患者中的分流价值.方法 收集2019年8月-2020年8月就诊于蚌埠医学院第一附属医院妇科,液基薄层细胞学(TCT)为ASCUS的患者,行(HPV)DNA检查、(HPV)E6/E7 mRNA检查,阳...

The shunt value of HPV E6/E7mRNA examination in cervical cytology ASCUS

Objective To explore the shunt value of human papillomavirus(HPV) E6/E7 mRNA examination in patients with atypical squamous epithelial cells(ASCUS) whose cervical cytology results are ambiguous. Methods Patients treated in the Department of Gynecology, the First Affiliated Hospital of Bengbu Medical College from August 2019 to August 2020, with liquid-based thin-layer cytology(TCT) as ASCUS, underwent(HPV) DNA examination and(HPV) E6/E7 mRNA examination were collected. The positive patients underwent colposcopy, the test results and cervical biopsy results were analyzed statistically, and the shunt value of HPV E6/E7 mRNA test in patients with ASCUS TCT results was discussed. Results The 231 ASCUS patients were divided into 117 cases of chronic cervical inflammation(50.65%), 65 cases of low-grade cervical intraepithelial lesions(28.14%), 47 cases of high-grade cervical intraepithelial lesions(20.35%), and 2 cases of cervical cancer(0.87%). 91 cases(39.39%) were HPV E6/E7 mRNA positive, 127 cases(54.98%) were HPV DNA positive, there was no significant difference in the detection rate of CINⅡ+between the two methods.(HPV) E6/E7 mRNA examination CINⅡ+(HISL+SCC) specificity was 69.2%, sensitivity was 71.4%, negative predictive value was 90.0%, positive predictive value was 38.5%. The specificity of HPV DNA examination CINⅡ+(HISL+SCC) was 53.3%, the sensitivity was 85.7%, the negative predictive value was 93.3%, and the positive predictive value was 33.1%. The specificity of(HPV) E6/E7 mRNA examination was significantly higher than that of(HPV) DNA, and the difference was statistically significant(χ2=26.273, P<0.001). The copy value of patients with different cervical lesions was counted and analyzed. As the lesion level progresses, the copy value of(HPV) E6/E7 mRNA also increased, the difference was statistically significant(ρ=0.562, P<0.001). The AUC of E6/E7 mRNA examination is 0.69, which was greater than the value of(HPV) DNA AUC(0.60), which was more efficient than(HPV) DNA examination. Conclusion(HPV) E6/E7 mRNA examination is a good shunt for patients with atypical squamous epithelial cells(ASCUS) whose TCT results are ambiguous. It can reduce the colposcopy referral rate, reducing the burden of patients and the work of clinicians, avoiding missed diagnosis and over-treatment, becoming a new method for triage of ASCUS patients.