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目的探讨高危型人乳头瘤病毒(HR-HPV)E6/E7 m RNA及HPV DNA检测与宫颈病变的关系。方法选取2013年1月至2015年12月在青岛市市立医院妇科门诊行宫颈癌联合筛查的两组女性:LCT+HRHPV DNA(HC2组,n=2 417);LCT+HR-HPV E6/E7 m RNA(E6/E7组,n=2 906)。细胞学ASCUS+或HPV阳性转诊阴道镜行宫颈活检。计算HPV m RNA E6/E7与HPV DNA在不同病理结果中的阳性率、病毒载量及在CIN2+中的一致率。结果 (1)在病理正常、CIN1、CIN2、CIN3和ICC中E6/E7 m RNA阳性率分别为61.36%、76.00%、92.11%、96.00%和100.00%,随病变程度加重而升高(P<0.05)。正常病理结果中E6/E7组HPV的阳性率低于HC2组(χ2=7.764,P=0.005)。(2)E6/E7组病毒载量的中位数和四分位数在不同病理结果中分别为629.72(339.31,2 122.94),1117.33(319.17,3 101.88),1 537.12(422.19,4 219.05),3 396.59(1 217.32,6 316.81),10 860.43(3 473.19,29 662.29),随着病变程度加重逐渐升高,差异有统计学意义(P<0.05)。(3)在CIN2+患者中,E6/E7组和HC2组的一致率为82.64%,Kappa值=0.69。结论 HPV E6/E7阳性率与HC2一样随着宫颈病变程度的加重逐渐升高。HPVE6/E7 m RNA与HPV DNA诊断CIN2+的一致性较好。HPV E6/E7载量可能反映病变程度,但还需进一步临床验证。
Objective To investigate the relationship between high-risk human papillomavirus (HR-HPV) E6 / E7 m RNA and HPV DNA detection and cervical lesions. Methods LCT + HRHPV DNA (HC2 group, n = 2 417) and LCT + HR-HPV E6 / LCV were screened in gynecology clinic of gynecology clinic of Qingdao Municipal Hospital from January 2013 to December 2015, E7 m RNA (group E6 / E7, n = 2 906). Cytology ASCUS + or HPV positive referral colposcopy cervical biopsy. The positive rates of HPV m RNA E6 / E7 and HPV DNA in different pathological results, viral load and concordance rate in CIN2 + were calculated. Results (1) The positive rates of E6 / E7 m RNA in CIN1, CIN2, CIN3 and ICC were 61.36%, 76.00%, 92.11%, 96.00% and 100.00%, respectively, which were increased with the severity of the disease (P < 0.05). The positive rate of HPV in E6 / E7 group was lower than that in HC2 group (χ2 = 7.764, P = 0.005). (2) The median and quartile of E6 / E7 group were 629.72 (339.31,2122.94), 1117.33 (319.17,3101.88) and 537.12 (422.19,419.05), respectively, in different pathological results , 3 396.59 (1 217.32, 6 316.81) and 10 860.43 (3 473.19, 29 662.29), respectively. The difference was statistically significant (P 0.05). (3) In CIN2 + patients, the consistency rate of E6 / E7 group and HC2 group was 82.64%, Kappa value = 0.69. Conclusions The positive rate of HPV E6 / E7, like HC2, gradually increases with the severity of cervical lesions. HPVE6 / E7 m RNA and HPV DNA diagnosis of CIN2 + is better. HPV E6 / E7 load may reflect the degree of disease, but further clinical validation.