Volume 19 Issue 2
Feb.  2021
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NI Chang-xue, WANG Yan, YE Guo-liu, WANG Cai-zhi. The shunt value of HPV E6/E7mRNA examination in cervical cytology ASCUS[J]. Chinese Journal of General Practice, 2021, 19(2): 198-201, 255. doi: 10.16766/j.cnki.issn.1674-4152.001766
Citation: NI Chang-xue, WANG Yan, YE Guo-liu, WANG Cai-zhi. The shunt value of HPV E6/E7mRNA examination in cervical cytology ASCUS[J]. Chinese Journal of General Practice, 2021, 19(2): 198-201, 255. doi: 10.16766/j.cnki.issn.1674-4152.001766

The shunt value of HPV E6/E7mRNA examination in cervical cytology ASCUS

doi: 10.16766/j.cnki.issn.1674-4152.001766
Funds:

 KJ2019A0343

  • Received Date: 2020-10-07
    Available Online: 2022-02-19
  •   Objective  To explore the shunt value of human papillomavirus (HPV) E6/E7 mRNA examination in patients with atypical squamous epithelial cells (ASCUS) whose cervical cytology results are ambiguous.  Methods  Patients treated in the Department of Gynecology, the First Affiliated Hospital of Bengbu Medical College from August 2019 to August 2020, with liquid-based thin-layer cytology (TCT) as ASCUS, underwent (HPV) DNA examination and (HPV) E6/E7 mRNA examination were collected. The positive patients underwent colposcopy, the test results and cervical biopsy results were analyzed statistically, and the shunt value of HPV E6/E7 mRNA test in patients with ASCUS TCT results was discussed.  Results  The 231 ASCUS patients were divided into 117 cases of chronic cervical inflammation (50.65%), 65 cases of low-grade cervical intraepithelial lesions (28.14%), 47 cases of high-grade cervical intraepithelial lesions (20.35%), and 2 cases of cervical cancer (0.87%). 91 cases (39.39%) were HPV E6/E7 mRNA positive, 127 cases (54.98%) were HPV DNA positive, there was no significant difference in the detection rate of CINⅡ+between the two methods. (HPV) E6/E7 mRNA examination CINⅡ+(HISL+SCC) specificity was 69.2%, sensitivity was 71.4%, negative predictive value was 90.0%, positive predictive value was 38.5%. The specificity of HPV DNA examination CINⅡ+(HISL+SCC) was 53.3%, the sensitivity was 85.7%, the negative predictive value was 93.3%, and the positive predictive value was 33.1%. The specificity of (HPV) E6/E7 mRNA examination was significantly higher than that of (HPV) DNA, and the difference was statistically significant (χ2=26.273, P < 0.001). The copy value of patients with different cervical lesions was counted and analyzed. As the lesion level progresses, the copy value of (HPV) E6/E7mRNA also increased, the difference was statistically significant (ρ=0.562, P < 0.001). The AUC of E6/E7 mRNA examination is 0.69, which was greater than the value of (HPV) DNA AUC (0.60), which was more efficient than (HPV) DNA examination.  Conclusion  (HPV) E6/E7 mRNA examination is a good shunt for patients with atypical squamous epithelial cells (ASCUS) whose TCT results are ambiguous. It can reduce the colposcopy referral rate, reducing the burden of patients and the work of clinicians, avoiding missed diagnosis and over-treatment, becoming a new method for triage of ASCUS patients.

     

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  • [1]
    MCGUIRE S. World Cancer Report 2014. Geneva, Switzerland: World Health Organization, International Agency for Research on Cancer, WHO Press, 2015[J]. Adv Nutr, 2016, 7(2): 418-419.
    [2]
    REN C, ZHU Y, YANG L, et al. Diagnostic performance of HPV E6/E7 mRNA assay for detection of cervical high-grade intraepithelial neoplasia and cancer among women with ASCUS Papanicolaou smears[J]. Arch Gynecol Obstet, 2018, 297(2): 425-432. doi: 10.1007/s00404-017-4588-1
    [3]
    BRUNO M T, FERRARA M, FAVA V, et al. A prospective study of women with ASCUS or LSIL pap smears at baseline and HPV E6/E7 mRNA positive: a 3-year follow-up[J]. Epidemiol Infect, 2018, 146(5): 612-618. doi: 10.1017/S0950268818000250
    [4]
    费小蔷, 沙敏, 叶军. 人乳头状瘤病毒标志物在宫颈疾病诊断中的研究进展[J]. 中华生物医学工程杂志, 2015, 21(4): 373-377. doi: 10.3760/cma.j.issn.1674-1927.2015.04.018
    [5]
    王兰英, 施姚, 张生枝, 等. E6/E7 mRNA检测在高危型人乳头瘤病毒DNA阳性且细胞学轻度异常患者随访中的作用[J]. 温州医科大学学报, 2018, 48(11): 818-821, 827. doi: 10.3969/j.issn.2095-9400.2018.11.008
    [6]
    王鹏, 郭珍, 赵冬梅, 等. 高危型人乳头瘤病毒E6/E7 mRNA对未明确意义的非典型鳞状上皮细胞人群分流的意义[J]. 中国肿瘤, 2019, 28(11): 876-882. doi: 10.11735/j.issn.1004-0242.2019.11.A012
    [7]
    SONG B, DING C, CHEN W, et al. Incidence and mortality of cervical cancer in China, 2013[J]. Chin J Cancer Res, 2017, 29(6): 471-476. doi: 10.21147/j.issn.1000-9604.2017.06.01
    [8]
    闫海洋, 闵少菊, 沈艳, 等. HPV E6/E7 mRNA检测在HPV分型及宫颈疾病筛查中的作用研究[J]. 中国实用妇科与产科杂志, 2018, 34(8): 923-927. https://www.cnki.com.cn/Article/CJFDTOTAL-ZGSF201808027.htm
    [9]
    RICHARDSON L A, EL-ZEIN M, RAMANAKUMAR A V, et al. HPV DNA testing with cytology triage in cervical cancer screening: Influence of revealing HPV infection status[J]. Cancer Cytopathol, 2015, 123(12): 745-754. doi: 10.1002/cncy.21596
    [10]
    GARCéS-PALACIO I C, SANCHEZ G I, BAENA ZAPATA A, et al. Psychosocial impact of inclusion of HPV test on the management of women with atypical squamous cells of undetermined significance: a study within a randomised pragmatic trial in a middle-income country[J]. Psychol Health, 2020, 35(6): 750-769. doi: 10.1080/08870446.2019.1678749
    [11]
    WANG Y, GAO S, WANG Y, et al. The efficiency of type-specific high-risk human papillomavirus models in the triage of women with atypical squamous cells of undetermined significance[J]. Cancer Manag Res, 2020, 12: 5265-5275. doi: 10.2147/CMAR.S254330
    [12]
    郎凯楠, 李文, 李亚平, 等. 高危型HPV E6/E7 mRNA检测对ASCUS患者分流价值的系统评价[J]. 郑州大学学报(医学版), 2018, 53(5): 604-609. https://www.cnki.com.cn/Article/CJFDTOTAL-HNYK201805014.htm
    [13]
    彭晶晶, 王荣敏, 尤志学. 对ASCCP 2012年宫颈癌筛查和癌前病变管理指南的解读[J]. 国际妇产科学杂志, 2015, 42(1): 116-120. https://www.cnki.com.cn/Article/CJFDTOTAL-GWVC201501036.htm
    [14]
    罗红学, 杜辉, 刘志红, 等. 不同亚型人乳头状瘤病毒感染合并细胞学异常者宫颈上皮内瘤变2级或3级及以上病变的患病风险评估[J]. 中华肿瘤杂志, 2018, 40(3): 232-238. doi: 10.3760/cma.j.issn.0253-3766.2018.03.015
    [15]
    陈文华, 毋崇岭, 何宝明. 女性宫颈病变患者HPV感染分布特点meta分析[J]. 实用癌症杂志, 2019, 34(2): 324-327. doi: 10.3969/j.issn.1001-5930.2019.02.041
    [16]
    朱远航, 任琛琛, 张小安, 等. HPV E6/E7 mRNA检测对ASCUS患者临床分层处理价值评价[J]. 实用妇产科杂志, 2017, 33(8): 595-598. https://www.cnki.com.cn/Article/CJFDTOTAL-SFCZ201708014.htm
    [17]
    黄珊珊, 徐凤娟, 成雁, 等. 高危型HPV E6/E7 mRNA与HC2 HPV-DNA联合检测在宫颈病变筛查中价值[J]. 中华实用诊断与治疗杂志, 2020, 34(6): 577-580. https://www.cnki.com.cn/Article/CJFDTOTAL-HNZD202006010.htm
    [18]
    VALENÇA J E, GONÇALVES A K, GUERREIRO DA SILVA I D, et al. High risk HPV E6/E7 oncoprotein expression in women with high grade squamous intraepithelial lesion[J]. Rev Bras Ginecol Obstet, 2016, 38(3): 154-159. doi: 10.1055/s-0036-1580713
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