摘要
目的:探讨高危型人乳头瘤病毒(HPV)E6/E7mRNA和HPV-DNA检测在宫颈癌筛查中的价值。方法:选取975名行宫颈癌筛查并获得病理结果者为研究对象,均行HPVE6/E7mRNA和HPV-DNA检测。分析不同组织病理学分级中HPVE6/E7mRNA与HPV-DNA检测结果的阳性率;以病理检测结果为金标准,评价HPV E6/E7mRNA、HPV-DNA检测及两者联合检测诊断上皮细胞内瘤变(CIN)≥Ⅰ级的敏感性、特异性、阳性预测值、阴性预测值及准确性。结果:随着组织病理学级别的升高,HPVE6/E7mRNA、HPV-DNA阳性率均呈逐渐上升的趋势(P<0.05)。对≥CINⅠ的诊断,HPVE6/E7mRNA检测的特异性、阳性预测值及准确性均高于HPV-DNA检测(P<0.05);敏感性低于HPV-DNA检测(P<0.05);两种检测方法的阴性预测值无统计学差异(P>0.05)。两者联合检测的敏感性及阴性预测值高于两者单独检测(P<0.05)。结论:HPVE6/E7mRNA和HPV-DNA检测对宫颈癌的筛查均有指导价值,HPVE6/E7mRNA检测辅助HPV-DNA检测使用,可弥补HPV-DNA检测特异性、阳性预测值等不足,提高诊断效能。
Objective:To investigate the clinical value of high-risk human papillomavirus(HPV)E6/E7 mRNA and HPV-DNA detection in cervical cancer screening.Methods:A total of 975 women who underwent cervical cancer screening and obtained pathological results were selected as subjects.All subjects underwent HPVE6/E7 mRNA and HPV-DNA detection.The positive rates of HPVE6/E7 mRNA and HPV-DNA detection results in different histopathological grades were analyzed.The sensitivity,specificity,positive predictive value,negative predictive value and accuracy of HPV E6/E7 mRNA detection,HPV-DNA detection and combined detection in the diagnosis of CIN I and above were evaluated by pathological examination results as the gold standard.Results:With the increase of histopathological level,the positive rates of HPVE6/E7 mRNA and HPV-DNA were gradually increased(P<0.05).For the diagnosis of CIN I and above,the specificity,positive predictive value and accuracy of HPVE6/E7 mRNA detection were higher than those of HPV-DNA detection(P<0.05).The sensitivity of HPVE6/E7 mRNA detection was lower than that of HPV-DNA detection(P<0.05).The negative predictive values of the two detection methods were not statistically significant(P>0.05).The sensitivity and negative predictive value of combined detection were significantly higher than those of single detection(P<0.05).Conclusion:HPVE6/E7 mRNA and HPV-DNA detection have obvious guiding value for cervical cancer screening.HPVE6/E7 mRNA detection assisted with HPV-DNA detection can compensate for the lack of specificity and positive predictive value of HPV-DNA detection,and improve the diagnostic efficiency.
作者
武振宇
WU Zhen-yu(Department of Microbiology,Zhangjiakou Maternal and Child Health Hospital,Zhangjiakou 075000,Hebei,China)
出处
《川北医学院学报》
CAS
2022年第10期1313-1316,共4页
Journal of North Sichuan Medical College
基金
河北省张家口市重点研发计划项目(2121092D)。
