文章摘要

HPV E6/E7 mRNA检测在宫颈癌筛查中的价值

作者: 1王旭东, 1刘羽
1 安徽医科大学附属妇幼保健院妇二科，合肥 230000
通讯: 刘羽 Email: 411321349@qq.com
DOI: 10.3978/j.issn.2095-6959.2022.06.004
基金: 合肥市卫生健康委员会2018年应用医学研究项目(hwk2018yb014)。

摘要

目的：分析在宫颈癌筛查中HPV E6/E7 mRNA检测的意义。方法：统计2018年10月至2020年5月于安徽省妇幼保健院行HPV分型检测妇女的检测结果。将上述妇女中HPV分型检测结果为高危型阳性、TCT结果示宫颈炎及以上者的患者纳入研究。所有患者行HPV E6/E7 mRNA检测及阴道镜下宫颈组织活检。采用SPSS 23.0软件行数据分析。结果：2018年10月至2020年5月共有17 648名妇女于安徽省妇幼保健院行HPV分型检测，累计检出了3 877例HPV DNA感染(包括单一和多重感染)，其中感染频率最高的前3种为HPV52(3.42%)、HPV16(3.33%)、HPV58(2.50%)。HPV检测结果为高危型阳性、TCT结果为慢性宫颈炎及以上的患者共有360例，其中HPV E6/E7 mRNA检测阳性的有195例，总阳性率为54.17%，包括宫颈炎组、CIN I组、CIN II~III组、宫颈癌组，阳性率分别为42.04%、54.55%、70.10%、75%。CIN II~III组阳性率显著高于宫颈炎组及CIN I组，差异有统计学意义(P<0.05)。单独分析TCT结果为不典型鳞状细胞(atypical squamous cell of undetermined significance，ASCUS)及低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion，LSIL)的患者，结果显示CIN II~III组阳性率显著高于宫颈炎组及CIN I组，差异有统计学意义(P<0.05)。ROC曲线下面积为0.644(P<0.05)，其最佳工作点为HPV E6/E7 mRNA拷贝数为871.105 copies/mL时，此时HPV E6/E7 mRNA检测高级别病变的敏感度为62.6%，特异度为65.3%。HPV E6/E7 mRNA拷贝数随着宫颈病变等级的提高逐渐增大，CIN组显著高于宫颈炎组，差异有统计学意义(P<0.05)。结论：在宫颈癌的筛查中，HPV E6/E7 mRNA检测具有较高的价值。
关键词： 人乳头瘤病毒；HPV E6/E7 mRNA；宫颈癌筛查

Value of HPV E6/E7 mRNA detection in cervical cancer screening

Authors: 1WANG Xudong, 1LIU Yu
1 Second Department of Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, Hefei 230000, China

CorrespondingAuthor: LIU Yu Email: 411321349@qq.com

DOI: 10.3978/j.issn.2095-6959.2022.06.004

Foundation: This work was supported by 2018 Applied Medical Research Project of Hefei Health Commission, China (HWK2018YB014).

Abstract

Objective: To analyze the significance of HPV E6/E7 mRNA detection in cervical cancer screening. Methods: The test results of women who underwent HPV typing test in Anhui Maternal and Child Health Hospital from October 2018 to May 2020 were statistically analyzed. And among the above women, those with positive HPV genotyping results and TCT results showing cervicitis or more serious were included in the study. All patients underwent HPV E6/E7 mRNA detection and cervical tissue biopsy under colposcope. All data were analyzed using SPSS 23.0 software. Results: From October 2018 to May 2020, a total of 17 648 women were tested for HPV genotyping in Anhui Maternal and Child Health Hospital. A total of 3 877 cases of HPV DNA infection (including single and multiple infections) were detected, among which the top three types of infection frequency were HPV52 (3.42%), HPV16 (3.33%), HPV58 (2.50%). There were 360 patients with HPV testing positive for high-risk type and TCT results showing chronic cervicitis or more serious, among which 195 women were HPV E6/E7 mRNA testing positive, with a total positive rate of 54.17%, including cervicitis group, CIN I group, CIN II–III group and cervical cancer group. The positive rates were 42.04%, 54.55%, 70.10% and 75%, respectively. The positive rate of CIN II–III group was significantly higher than that of cervicitis group and CIN I group, the differences were statistically significant (P<0.05). The positive rate of CIN II–III group was significantly higher than that of cervicitis group and CIN I group when all the patients’ TCT results showed ASCUS or LSIL (P<0.05). The area under ROC curve was 0.644 (P<0.05), and the optimal operating point was when the copy number of HPV E6/E7 mRNA was 871.105 copies/mL. At this time, the sensitivity and specificity of HPV E6/E7 mRNA in detecting high-grade lesions were 62.6% and 65.3% respectively. The copy number of HPV E6/E7 mRNA increased gradually with the increase of cervical lesion grade, and that of CIN group was significantly higher than that of cervicitis group, with statistical significance (P<0.05). Conclusion: The HPV E6/E7 mRNA detection is highly valuable in cervical cancer screening. 

Keywords： human papillomavirus; HPV E6/E7 mRNA; cervical cancer screening

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