[1]李晓林,李婧,陈龙,等.高危型人乳头瘤病毒E 6/E 7 mRNA检测在意义不明的非典型鳞状上皮细胞中的分流价值[J].中国计划生育和妇产科,2017,(2):55-59.
　LI Xiao-lin,LI Jing,CHEN Long,et al.Value of high-risk human papillomavirus E6 / E7 mRNA in atypical squamous cells of undetermined significance triage[J].Chinese Journal of Family Planning & Gynecotokology,2017,(2):55-59.
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高危型人乳头瘤病毒E 6/E 7 mRNA检测在意义不明的非典型鳞状上皮细胞中的分流价值
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《中国计划生育和妇产科》[ISSN:1674-4020/CN:51-1708/R]

卷:
期数:
2017年2期
页码:
55-59
栏目:
论著与临床
出版日期:
2017-02-25

文章信息/Info

Title:
Value of high-risk human papillomavirus E6 / E7 mRNA in atypical squamous cells of undetermined significance triage
作者:
李晓林; 李婧; 陈龙; 范俊*
青岛大学附属青岛市立医院
Author(s):
LI Xiao-lin; LI Jing; CHEN Long; FAN Jun*
Center of Gynecology, Qingdao Municipal Hospital Affiliated of Qingdao University, Qingdao Shandong 266071，PR.China
关键词:
高危型人乳头瘤病毒; E 6/E 7 mRNA; 意义不明的非典型鳞状细胞
Keywords:
high-risk human papillomavirus;  E6/E7 mRNA;  ASCUS
分类号:
R 711.74
摘要:
目的研究高危型人乳头瘤病毒（high-risk human papillomavirus，hrHPV）E 6/E 7 mRNA在结果意义不明的非典型鳞状上皮细胞（atypical squamous cells of undetermined significance，ASCUS）中的分流效率，探索其在ASCUS分流中的临床价值。方法选取2013年至2015年在青岛市立医院妇科门诊行细胞学筛查结果为ASCUS的女性405例，年龄21~65岁。根据HPV检测方法，分为3组：HC2组、HPV分型组、hrHPV E 6/E 7 mRNA（E6/E7）组。比较3种HPV检测方法分流ASCUS的灵敏度、特异度、阳性预测值、阴性预测值、阴道镜转诊率、CIN 2+/CIN 3+检出率。结果① E 6/E 7分流ASCUS的CIN 2+灵敏度为10000 %（9051 %~10000 %），CIN 2+/CIN 3+的特异度分别为6484 %（5306 %~7599 %）、5646 %（4398 %~6972 %），阴性预测值分别为10000 %（9941 %~10000 %）、10000 %（9934 %~10000 %），与HC2和HPV分型比较差异无统计学意义（P>005）。阳性预测值分别为4079 %（3791%~4429 %）、1579 %（1007 %~2094 %），高于HC2（P<005）。阴道镜转诊率为4780 %，低于HC2和HPV分型（P<005）。CIN 2+检出率为1950 %，高于HC2（P<005）。② E 6/E 7分流ASCUS检测CIN 2+的曲线下面积为0815，＞HC2和HPV分型（P<005）。结论hrHPV E 6/E 7 mRNA分流ASCUS的灵敏度、特异度与HC2相似，PPV和CIN 2+检出率更高，阴道镜转诊率更低，可用于ASCUS的分流。
Abstract:
ObjectiveTo explore high-risk human papillomavirus（hrHPV） E6 / E7 mRNA performance in atypical squamous cells of undetermined significance（ASCUS） triage， and to research the clinical value and feasibility in cervical screening. Methods405 women with ASCUS result in Qingdao Municipal Hospital Affiliated of Qingdao University from 2013 to 2015 were selected,who were between 21 and 65 years old. According to the HPV triage tests, patients were divided into three groups: HC2 group，HPV genotyping group and hrHPV E6 / E7 mRNA (E6/E7) group. We compared the accuracy of three triage methods, including sensitivity, specificity, positive predictive value（PPV）, negative predictive value（NPV）, colposcopy referral rate, CIN 2+ / CIN 3+ detection rate. Results① The sensitivities for CIN 2+ of ASCUS triage by E6/E7 were 10000% (9051% ~10000%), specificities for CIN 2+/CIN 3+ were 6484% (5306% ~7599%), 5646% (4398%~6972%), NPVs were 10000% (9941%~10000%), 10000% (9934%~10000%) respectively, without significant difference compared with HC2 and genotyping(P>005). PPVs were 4079% (3791%~4429%), 1579% (1007% ~2094%), higher than HC2 (P<005). The colposcopy referral rate was 4780%, lower than HC2 and genotyping (P>005). CIN 2+ detection rate was 1950%, higher than HC2, the difference was statistically significant (P<005). ② The AUC of E6/E7 for CIN 2+ were 0815,higher than HC2 and HPV genotyping statistically（P<005）.ConclusionThe sensitivity and specificity of ASCUS triage by hrHPV E6/E7 mRNA is similar with HC2, with higher PPV and CIN 2+ detection rate and lower colposcopy referral rate. It is valuable in ASCUS triage.

参考文献/References:

［1］Jemal A, Bray F, Center MM, et al Global cancer statistics ［J］ CA Cancer J Clin, 2011, 61(2): 69-90. ［2］IARC Working Group on the Evaluation of Carcinogenic Risks to Humans. A review of human carcinogens ［J］.IARC Monogr Eval Carcinog Risks Hum, 2012, 100(Pt B)：1-441. ［3］Cuschieri S, Whitley J, Cubie A. Human papillomavirus type specific DNA and RNA persistence——implications for cervical disease progression and monitoring ［J］. J Med Virol, 2004, 73(1): 65-70. ［4］Cuschieri K, Wentzensen N. Human papillomavirus mRNA and p16 detection as biomarkers for the improved diagnosis of cervical neoplasia ［J］. Cancer Epidemiol Biomarkers Prev, 2008, 17(10): 2536-2545. ［5］Basu Partha, Banerjee Dipanwita, Mittal Srabani, et al. Sensitivity of APTIMA HPV E6/E7 mRNA test in comparison with hybrid capture 2 HPV DNA test for detection of high risk oncogenic human papillomavirus in 396 biopsy confirmed cervical cancers ［J］. J Med Virol, 2016, 88(7): 1271-1278. ［6］Gustinucci Daniela, Giorgi Rossi Paolo, Cesarini Elena, et al. Use of cytology, E6/E7 mRNA, and p16INK4a-Ki-67 to define the management of human papillomavirus (HPV)-Positive women in cervical cancer screening ［J］. Am J Clin Pathol, 2016, 145(1): 35-45. ［7］Castle E, Cuzick Jack, Stoler H, et al. Detection of human papillomavirus 16, 18, and 45 in women with ASC-US cytology and the risk of cervical precancer: results from the CLEAR HPV study ［J］. Am J Clin Pathol, 2015, 143(2): 160-167. ［8］Szarewski A, Mesher D, Cadman L, et al. Comparison of seven tests for high-grade cervical intraepithelial neoplasia in women with abnormal smears: the Predictors 2 study ［J］. J Clin Microbiol, 2012, 50(6): 1867-1873. ［9］Stoler H, Wright C, Cuzick Jack, et al. APTIMA HPV assay performance in women with atypical squamous cells of undetermined significance cytology results ［J］. Am J Obstet Gynecol, 2013, 208(2): 144.e1-144.e8. ［10］钞晓培，谭先杰.人乳头瘤病毒癌基因E6/E7 mRNA检测及其在宫颈病变筛查中的应用价值［J］.中国计划生育和妇产科，2016，8 （10）：15-18. ［11］LIU Tong, Xie Rong, Luo Li, et al. Diagnostic validity of human papillomavirus E6/E7 mRNA test in cervical cytological samples ［J］. J Virol Methods, 2014, 196(2): 120-125. ［12］刘国强，张朝红，谢映君，等高危型人乳头瘤病毒联合液基细胞学检测在宫颈癌前病变筛查中的应用 ［J］中国计划生育和妇产科，2015，7（6）：43-45 ［13］Solomon Diane, Davey Diane, Kurman Robert, et al. The 2001 bethesda system: terminology for reporting results of cervical cytology ［J］. JAMA, 2002, 287(16): 2114-2119. ［14］Tommasino M. The human papillomavirus family and its role in carcinogenesis ［J］. Semin Cancer Biol, 2014, 26(4): 13-21. ［15］Arbyn Marc, Roelens Jolien, Cuschieri Kate, et al. The APTIMA HPV assay versus the Hybrid Capture 2 test in triage of women with ASC-US or LSIL cervical cytology: a meta-analysis of the diagnostic accuracy ［J］. International Journal of Cancer, 2013, 132(1): 101-108. ［16］Burroni Elena, Sani Cristina, Bisanzi Simonetta, et al. HPV primary test in the cervical cancer screening: reproducibility assessment and investigation on cytological outcome of Hybrid Capture 2 borderline samples ［J］. Epidemiol Prev, 2016, 40(3/4): 164-170. ［17］Castle E, Reid Jennifer, Dockter Janel, et al. The reliability of high-risk human papillomavirus detection by Aptima HPV assay in women with ASC-US cytology ［J］. J Clin Virol, 2015, 69 （5）: 52-55. ［18］Zou Ruan-min, Xie Wang-kai, Wang Hui-jing, et al. Establishment and application of a method for high-risk human papillomavirus genotyping in cervical cancer tissue ［J］. Clin Lab, 2016, 62(6): 1075-1085.

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更新日期/Last Update: 2017-02-25