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目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA检测在宫颈病变过程中的应用价值。方法收集137例宫颈病变疑似患者的HPV DNA、HPV E6/E7 mRNA、薄层液基细胞学检测(TCT)以及组织病理检测结果,综合比较分析HPV E6/E7 mRNA检测的潜在应用价值。结果 HPV E6/E7 mRNA阳性率为77.1%,低于HPV DNA检测。而在更高病理级别样本中(≥CINⅡ),HPV E6/E7 mRNA检测灵敏度为80.3%,特异度为50.0%,阳性预测值为56.3%以及阴性预测值为76.0%。HPV E6/E7 mRNA的ROC曲线线下面积为0.652,95%CI为0.571~0.732,HPV DNA为0.630,0.547~0.713(P=0.0045)。经过长期治疗观察与跟踪研究整理,相对比HPV DNA检测,HPV E6/E7 mRNA的对CINⅠ和CINⅡ阳性病例的预测比例与病理进程更加符合。结论 HPV E6/E7 mRNA对宫颈病变的监测与诊断预测具有明显的指导意义。
Objective To investigate the value of detecting HPV E6 / E7 mRNA in cervical lesions. Methods The HPV DNA, HPV E6 / E7 mRNA, TLCT and histopathological examination of 137 cases of cervical lesions were collected, and the potential value of HPV E6 / E7 mRNA detection was compared and analyzed. Results The positive rate of HPV E6 / E7 mRNA was 77.1%, lower than HPV DNA test. In the higher pathological grade (≥CINⅡ), the detection sensitivity of HPV E6 / E7 mRNA was 80.3%, the specificity was 50.0%, the positive predictive value was 56.3% and the negative predictive value was 76.0%. The area under the ROC curve of HPV E6 / E7 mRNA was 0.652 with a 95% CI of 0.571-0.732 and HPV DNA of 0.630 and 0.547-0.713 (P = 0.0045). After long-term therapeutic observation and follow-up study, HPV DNA E6 / E7 mRNA was more consistent with pathological progress than HPV DNA test in predicting CINⅠand CINⅡpositive cases. Conclusion HPV E6 / E7 mRNA has obvious guiding significance in the monitoring and diagnosis of cervical lesions.