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目的探讨人乳头瘤病毒(HPV)E6/E7 mRNA检测在HPV阳性患者分流中的应用价值。方法选取2015年5月-2016年4月就诊于吉林大学第一医院的200例行柏氏液基细胞学检测(TCT)且经HPV DNA检测证实为HPV阳性的患者,行HPV E6/E7 mRNA检测、活检及病理学检查,分析结果之间的关系。结果不同TCT分级的病变间HPV E6/E7 mRNA阳性率比较差异有统计学意义,且HPV E6/E7 mRNA阳性率与TCT分级呈正相关(F=9.474,P<0.05)。HPV E6/E7 mRNA拷贝数与TCT分级也呈正相关(P<0.05)。不同病理分级的病变间HPV E6/E7 mRNA阳性率比较差异有统计学意义,且HPV E6/E7 mRNA阳性率与病理分级呈正相关(F=33.563,P<0.05)。HPV E6/E7 mRNA拷贝数与病理分级也呈正相关(P<0.05)。HPV E6/E7 mRNA检出CIN 2+宫颈病变的敏感性为80.70%,特异性为60.40%,阳性预测值为69.40%,阴性预测值为76.30%。结论HPV E6/E7 mRNA表达与宫颈病变程度密切相关。HPV E6/E7 mRNA检测用于HPV阳性患者分流可有效排除风险,减少对HPV阳性患者的过度诊疗。
Objective To investigate the value of detecting HPV E6 / E7 mRNA in shunting of HPV-positive patients. Methods Two hundred 200 BCT-based cytology (TCT) patients who were diagnosed at the First Hospital of Jilin University from May 2015 to April 2016 were selected and HPV E6 / E7 mRNA was detected by HPV DNA test , Biopsy and pathological examination, analysis of the relationship between the results. Results The positive rate of HPV E6 / E7 mRNA was significantly different between different TCT grading lesions. The positive rate of HPV E6 / E7 mRNA was positively correlated with TCT grade (F = 9.474, P <0.05). HPV E6 / E7 mRNA copy number and TCT grade was also positively correlated (P <0.05). The positive rates of HPV E6 / E7 mRNA in pathological grading were statistically different, and the positive rate of HPV E6 / E7 mRNA was positively correlated with pathological grade (F = 33.563, P <0.05). HPV E6 / E7 mRNA copy number and pathological grade were also positively correlated (P <0.05). HPV E6 / E7 mRNA detected CIN2 + cervical lesions sensitivity was 80.70%, specificity was 60.40%, the positive predictive value was 69.40%, the negative predictive value was 76.30%. Conclusion The expression of HPV E6 / E7 mRNA is closely related to the degree of cervical lesions. Detection of HPV E6 / E7 mRNA for shunting in patients with HPV-positive can effectively eliminate the risk and reduce over-diagnosis of HPV-positive patients.