液基薄层细胞学检查联合人乳头瘤病毒E6/E7 mRNA检测在宫颈病变筛查中的价值分析
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摘要
目的探讨薄层液基细胞学检查(thinprep cytology test,TCT)联合人乳头瘤病毒(human papillomavirus,HPV) E6/E7mRNA检测在宫颈疾病筛查中的应用效果。方法选取538例患者作为研究对象,所有患者均行TCT、HPV E6/E7检测和阴道镜下宫颈多点活检,比较单独使用TCT或HPV E6/E7 mRNA以及联合TCT和HPV E6/E7 mRNA检测在宫颈病变筛查中的诊断价值。结果以病理学检查作为检测金标准,TCT和HPV E6/E7这两种检测方法对于宫颈病变均具有一定的筛检率,TCT检测的灵敏度66. 56%,特异度为53. 57%,HPV E6/E7 mRNA检测的灵敏度74. 84%,特异度为77. 68%,TCT联合HPV E6/E7mRNA检测的灵敏度和特异度分别为99. 68%和39. 29%。结论 TCT联合HPV E6/E7 mRNA检测在宫颈病变筛查中可大幅度提高灵敏度,降低临床漏诊率,具有临床筛查价值。
Objective To investigate the application value of thinprep cytology test(TCT) combined with human papillomavirus(HPV) E6/E7 mRNA detection in cervical disease screening. Methods A total of 538 cases were detected with gynecological disorders received TCT,HPV E6/E7 and colposcopy cervical biopsy. To compare the diagnostic value of TCT or HPV E6/E7 mRNA alone with combined TCT and HPV E6/E7 mRNA in cervical lesion screening. Results Compared with pathological examination for cervical disease diagnosis,the sensitivity and specificity of TCT was 66. 56% and 53. 57% respectively,the sensitivity and specificity of HPV E6/E 7 mRNA was 74. 84% and 77. 68% respectively while the sensitivity and specificity of joint detection of TCT and HPV E6/E7 mRNA was99. 68% and 39. 29% respectively. Conclusion The joint detection of TCT and HPV E6/E7 mRNA raises the sensitivity remarkably in cervical disease screening,reduces missed clinic diagnosis rate and contributes to clinic cervical disease screening.
Objective To investigate the application value of thinprep cytology test(TCT) combined with human papillomavirus(HPV) E6/E7 mRNA detection in cervical disease screening. Methods A total of 538 cases were detected with gynecological disorders received TCT,HPV E6/E7 and colposcopy cervical biopsy. To compare the diagnostic value of TCT or HPV E6/E7 mRNA alone with combined TCT and HPV E6/E7 mRNA in cervical lesion screening. Results Compared with pathological examination for cervical disease diagnosis,the sensitivity and specificity of TCT was 66. 56% and 53. 57% respectively,the sensitivity and specificity of HPV E6/E 7 mRNA was 74. 84% and 77. 68% respectively while the sensitivity and specificity of joint detection of TCT and HPV E6/E7 mRNA was99. 68% and 39. 29% respectively. Conclusion The joint detection of TCT and HPV E6/E7 mRNA raises the sensitivity remarkably in cervical disease screening,reduces missed clinic diagnosis rate and contributes to clinic cervical disease screening.
引文
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[11]Munkhdelger J,Choi Y,Lee D,et al.Comparison of the performance of the Nucli SENS Easy Q HPV E6/E7 mRNA assay and HPV DNA chip for testing squamous cell lesions of the uterine cervix[J].Diagn Microbiol Infect Dis,2014,79(4):422-427.
[12]Chernesky M,Jang D,Gilchrist J,et al.Evaluation of a new APTIMA specimen collection and transportation kit for highrisk humanpap-illomavirus E6/E7 messenger RNA in cervical and vaginal samples[J].Sex Transm Dis,2014,41(6):365-368.
[13]林爽.王翠峰.HPV E6/E7mRNA检测在宫颈癌中的研究进展[J].现代预防医学,2018,45(3):513-519.
[14]Pan D,Zhang C Q,Liang Q L,et al.An efficient method that combines the Thin Prep cytologic test with E6/E7 mR-NA testing for cervical cancer screening[J].Cancer Manag Res,2019,11:4773-4780
[15]Han L,Husaiyin S,Zhao F,et al.Clinical Value of human papillomavirus E6/E7 mRNA detection in screening for cervical cancerin women positive for human papillomavirus DNA[J].Clin Lab,2018,64(9):1363-1371.
[2]郑嵘,徐真.TCT联合DNA倍体细胞检测在宫颈癌筛查中的应用效果[J].实用癌症杂志,2015,30(7):967-969.
[3]Al-Kholy A F,Abdullah O A,Abadier M Z,et al.Pre-treatment serum inflammatory cytokines as survival predictors of patients with nasopharyngeal carcinoma receiving chemoradiotherapy[J].Mol Clin Oncol,2016,5(6):811-816.
[4]Lin C T,Qiu J T,Wang C J,et al.Topical imiquimod treatment for human papillomavirus infection in Patients with and without cervical/vaginal intraepithelial neoplasia[J].Taiwan J Obstet Gynecol,2012,5l(4):533-538.
[5]Scholl S M,Kamal M,De Koning L,et al.HPV Pathway profiling:HPV related cervical dysplasia and carcinoma studies[J].Curr Pharm Des,2013,19(8):1379-1394
[6]陈炎添,陈青龙,熊燕,等.HR-HPV DNA PCR联合TCT检测对宫颈癌前病变的诊断价值[J].检验医学,2013,28(6):516-518.
[7]魏萌.探讨人乳头瘤病毒DNA分型检测联合宫颈液基薄层细胞学检查在宫颈癌筛查诊断中的作用[J].中国妇幼保健,2016,31(16):3264-3266.
[8]Karimi-Zarchi M,Peighmbari F,Karimi N,et al.A comparison of 3 ways of conventional pap smear,liquid-based cytology and colposcopy vs cervical biopsy for early diagnosis of premalignant lesions or cervical cancer in women with abnormal conventional pap test[J].Int J Biomed Sci,2013,9(4):205-210
[9]Pan Q J,Hu S Y,Zhang X,et al.Pooled analysis of the performance ofliquid-based cytology in population-based cervical cancer screening studies in China[J].Cancer Cytopathol,2013,121(9):473-482.
[10]张文晶,刘志强.宫颈癌筛查现状及其应用现状[J].医学综述,2017,23(9):1732-1736
[11]Munkhdelger J,Choi Y,Lee D,et al.Comparison of the performance of the Nucli SENS Easy Q HPV E6/E7 mRNA assay and HPV DNA chip for testing squamous cell lesions of the uterine cervix[J].Diagn Microbiol Infect Dis,2014,79(4):422-427.
[12]Chernesky M,Jang D,Gilchrist J,et al.Evaluation of a new APTIMA specimen collection and transportation kit for highrisk humanpap-illomavirus E6/E7 messenger RNA in cervical and vaginal samples[J].Sex Transm Dis,2014,41(6):365-368.
[13]林爽.王翠峰.HPV E6/E7mRNA检测在宫颈癌中的研究进展[J].现代预防医学,2018,45(3):513-519.
[14]Pan D,Zhang C Q,Liang Q L,et al.An efficient method that combines the Thin Prep cytologic test with E6/E7 mR-NA testing for cervical cancer screening[J].Cancer Manag Res,2019,11:4773-4780
[15]Han L,Husaiyin S,Zhao F,et al.Clinical Value of human papillomavirus E6/E7 mRNA detection in screening for cervical cancerin women positive for human papillomavirus DNA[J].Clin Lab,2018,64(9):1363-1371.