HPV-E<sub>6</sub>/E<sub>7</sub> mRNA检测在非16、18型高危HPV感染患者分层管理中的意义

储继承; 何玉; 叶国柳; 王立群

doi:10.16766/j.cnki.issn.1674-4152.003025

HPV-E₆/E₇ mRNA检测在非16、18型高危HPV感染患者分层管理中的意义

doi: 10.16766/j.cnki.issn.1674-4152.003025

蚌埠医学院第一附属医院妇产科，安徽蚌埠 233004

基金项目:

安徽省教育厅重点项目 KJ2019A0343

蚌埠医学院自然科学重点项目 BYKY2019119ZD

详细信息

通讯作者:
何玉，E-mail：heyu1972@163.com

中图分类号: R711.32 R373
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- 文章访问数: 320
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-16
- 网络出版日期: 2023-08-26

Significance of HPV-E₆/E₇ mRNA examination in stratification management of non 16 and 18 high risk HPV infection patients

Department of Obstetrics and Gynecology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨人乳头瘤病毒(HPV)-E₆/E₇ mRNA检测在非16、18型高危HPV感染且宫颈液基细胞学结果为未见上皮内病变细胞或恶性病变(NILM)患者临床分层管理中的应用价值。方法分析2020年10月—2021年10月就诊于蚌埠医学院第一附属医院非16、18型高危HPV感染且宫颈TCT阴性而行HPV-E₆/E₇ mRNA检测及阴道镜下活检的383例患者的临床资料，分析HPV-E₆/E₇ mRNA检测在不同级别宫颈病变中的表达水平。结果 383例患者中，慢性宫颈炎组252例、低级别上皮内病变组98例、高级别上皮内病变及以上组33例，HPV-E₆/E₇ mRNA阳性检出率分别为40.5%、64.3%、66.7%，差异有统计学意义(P＜0.001)，HPV-E₆/E₇ mRNA检测表达水平与子宫颈病变程度呈正相关关系(r=0.254，P＜0.05)。HPV-E₆/E₇ mRNA检测方法的AUC为0.623，cutoff值为741.092 copies/mL，此时检测出高级别上皮内病变(HSIL)及以上病变的灵敏度、特异度分别为63.6%、64.3%，约登指数为0.279。结论 HPV-E₆/E₇ mRNA检测对于非16、18型高危HPV阳性、TCT阴性患者的分层管理有较好的应用价值，有望降低阴道镜转诊率。
- 信使核糖核酸 /
- 高危型人乳头瘤病毒 /
- 分层管理
Abstract: Objective To evaluate the application value of the human papilloma virus (HPV)-E₆/E₇mRNA examination in stratification management of patients with non-16 and 18 high-risk HPV infection and atypical squamous cell of negative for intraepithelial lesion or malign (NILM). Methods The clinical data of 383 patients with HPV-E₆/E₇ mRNA detection and colposcopy biopsy who were not at high risk of HPV infection type 16 and 18 and had negative cervical TCT at the First Affiliated Hospital of Bengbu Medical College from October 2020 to October 2021 were analyzed. The expression levels of HPV-E₆/E₇ mRNA were analyzed in different levels of cervical lesions. Results The 383 patients were divided into 252 cases of chronic cervical inflammation, 98 cases of low-grade squamous intraepithelial lesion (LSIL), and 33 cases of high-grade squamous intraepithelial lesion and above (HSIL+). The positive rate of HPV-E₆/E₇ mRNA were 40.5%, 64.3% and 66.7%, respectively (P < 0.001). There was a positive correlation between the pathological grade of cervical lesions and the expression of HPV-E₆/E₇ mRNA (r=0.254, P < 0.05). The AUC of HPV-E₆/E₇ mRNA examination was 0.623 and cut-off was 741.092 copies/mL. When cut-off was used as criteria for HSIL and above lesions, the sensitivity and specificity of HPV-E₆/E₇ mRNA were 63.6% and 64.3%, respectively, and the Youden index was 0.279. Conclusion HPV-E₆/E₇ mRNA have an important value for stratification management in patients with high-risk HPV non-16 and 18 infection and negative cervical TCT, which is hopeful to reduce the colposcopy referral rate.
- Messenger ribonucleic acid /
- High-risk human papilloma virus /
- Stratification management

HTML全文

图 1 HSIL及以上患者HPV-E₆/E₇ mRNA检测的ROC曲线

Figure 1. ROC curve of HPV-E₆/E₇ mRNA detection in patients with HSIL and above

下载: 全尺寸图片幻灯片

表 1 不同程度宫颈病变中HPV-E₆/E₇ mRNA检出率[例(%)]

Table 1. The detection rate of HPV-E₆/E₇ mRNA in different degrees of cervical lesions [cases(%)]

组别	例数	HPV-E₆/E₇ mRNA结果
组别	例数	阴性	阳性
宫颈慢性炎	252	150(59.5)	102(40.5)
LISL	98	35(35.7)	63(64.3)
HISL及以上	33	11(33.3)	22(66.7)
χ²值		20.609
P值		＜0.001

下载: 导出CSV

表 2 不同程度宫颈病变中HPV-E₆/E₇ mRNA水平

Table 2. HPV-E₆/E₇ mRNA levels in different degrees of cervical lesions

组别	例数	HPV-E₆/E₇ mRNA拷贝值[M(P₂₅, P₇₅), copies/mL]
宫颈慢性炎	252	0.000(0.000, 1 139.463)
LISL	98	811.772(0.000, 4 017.910)
HISL及以上	33	1 002.969(0.000, 5 146.578)
H值		24.791
P值		＜0.001

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