HPV E7蛋白在宫颈疾病筛查中的临床意义
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摘要
目的探讨人乳头瘤病毒(HPV)E7蛋白检测在宫颈病变筛查中的作用及临床应用价值。方法选取2017年6月至2018年7月该院妇产科门诊就诊的300例女性为研究对象。对所有研究对象进行液基薄层细胞学检查(TCT)、HPV DNA检查,筛选出A组为TCT(-)高危HPV(hr-HPV)(+)组、B组为TCT(+)hr-HPV(+)组、C组为TCT(+)hr-HPV(-)组各100例,对这3组患者进行阴道镜检查及HPV E7蛋白检测。结果 (1)在A组,阴道镜检查的阳性检出率为50.00%,HPV E7蛋白阳性检出率为58.00%,两组数据相比,差异有统计学意义(P<0.05)。(2)在B组和C组中,HPV E7蛋白阳性检出率和阴道镜检查的阳性检出率相比,差异无统计学意义(P>0.05)。(3)HPV E7蛋白检测阳性率在正常宫颈、低度鳞状上皮内病变(LSIL)、高度鳞状上皮内病变(HSIL)和宫颈鳞癌(SCC)各组中表达不同,随细胞学诊断升级而增高,各组间差异有统计学意义(P<0.05)。(4)HPV E7蛋白检测随宫颈病变由LSIL到SCC病理学级别加重而显著增高(P<0.05)。结论 HPV E7蛋白的检测能够显著提高宫颈癌患者的诊断正确率,提高筛查率,对宫颈癌的临床诊断具有重要意义。
Objective To explore the role and clinical value of Human papillomavirus(HPV)E7 protein in the screening of cervical lesions.Methods A total of 300 women underwent thin cytology test(TCT)and HPV DNA test.They were divided into three groups who received colposcopy pathology and HPV E7 protein detection.Results In the TCT(-)hr-HPV(+)group,the positive detection rate of colposcopy was50.00%,and the positive detection rate of HPV E7 protein was 58.00%.There was a significant difference between the two groups(P<0.05).In the TCT(+)hr-HPV(+)group and TCT(+)hr-HPV(-)group,there was no significant difference between the positive detection rate of HPV E7 protein and the positive detection rate of colposcopy(P>0.05).The positive rate of HPV E7 protein detection was different in the normal cervical,low-grade squamous intraepithelial lesions(LSIL),high-grade squamous intraepithelial lesions(HSIL)and squamous cell carcinoma(SCC)groups,and increased with the cytological diagnosis and upgrade.The difference between the groups was statistically significant(P<0.05).The detection of HPV E7 protein significantly increased with the aggravation of cervical diseases from LSIL to SCC(P<0.05).Conclusion Compared with colposcopy,HPV E7 protein detection could improve the diagnostic rate of cervical lesions,which has important value in clinic.HPV E7 protein detection can be used as the main screening method for cervical lesions.
Objective To explore the role and clinical value of Human papillomavirus(HPV)E7 protein in the screening of cervical lesions.Methods A total of 300 women underwent thin cytology test(TCT)and HPV DNA test.They were divided into three groups who received colposcopy pathology and HPV E7 protein detection.Results In the TCT(-)hr-HPV(+)group,the positive detection rate of colposcopy was50.00%,and the positive detection rate of HPV E7 protein was 58.00%.There was a significant difference between the two groups(P<0.05).In the TCT(+)hr-HPV(+)group and TCT(+)hr-HPV(-)group,there was no significant difference between the positive detection rate of HPV E7 protein and the positive detection rate of colposcopy(P>0.05).The positive rate of HPV E7 protein detection was different in the normal cervical,low-grade squamous intraepithelial lesions(LSIL),high-grade squamous intraepithelial lesions(HSIL)and squamous cell carcinoma(SCC)groups,and increased with the cytological diagnosis and upgrade.The difference between the groups was statistically significant(P<0.05).The detection of HPV E7 protein significantly increased with the aggravation of cervical diseases from LSIL to SCC(P<0.05).Conclusion Compared with colposcopy,HPV E7 protein detection could improve the diagnostic rate of cervical lesions,which has important value in clinic.HPV E7 protein detection can be used as the main screening method for cervical lesions.
引文
[1]WANG H Y,LEE D,PARK S,et al.Diagnostic Performance of HPV E6/E7mRNA and HPV DNA Assays for the Detection and Screening of Oncogenic Human Papillomavirus Infection among Woman with Cervical Lesions in China[J].Asian Pac J Cancer Prev,2015,16(17):7633-7640.
[2]EGAWA N,EGAWA K,GRIFFIN H,et al.Human Papillomaviruses,Epithelial Tropisms,and the Development of Neoplasia Viruses[J].Viruses,2015,7(7):3863-3890.
[3]李秀,杨姗姗,安然.宫颈液基薄层细胞学检测(TCT)联合阴道镜在筛查宫颈病变中的价值[J].中国实验诊断学,2013,17(9):1644-1647.
[4]ABRAHAM J,STENGER M.COBAS HPV test for first-line screening for cervical cancer[J].J Community Support Oncol,2014,12(5):156-157.
[5]GROVES I J,COLEMAN N.Pathogenesis of human papillomavirus associated mucosal disease[J].J Pathol,2015,235(4):527-538.
[6]LAWSON H W.Practice Bulletin No.157:Cervical Cancer Screening and Prevention[J].Obstet Gynecol,2016,127(1):e1-e20.
[7]ZHANG L,LI Q,ZHAO M,et al.Discrepancies between biopsy-based and excision-based grading of cervical intraepithelial neoplasia:the important role of time between excision ang biopsy[J].Int Gynecol Pathol,2015,34(3):221-227.
[8]LU X,LIN M.Multiple-integrations of HPV16genome and altered transcription of viral oncogenes dan cellular genes are associated with the development of cervical cancer[J].PLoS One,2014,9(7):75-88.
[9]GUSTINUCCI D,GIORGI ROSSI P,CESARINI E,et al.Use of Cytology E6/E7 mRNA and p16INK4a-Ki-67to Define the Management of Human Papillomavirus(HPV)-Positive Women in Cervical Cancer Screening[J].Am J Clin Pathol,2016,145(1):35-45.
[10]赵琳琳.宫颈细胞HPV E6/E7mRNA检测在宫颈诊断价值中的分析[J].数理医药学杂志,2018,5(7):647-648.
[2]EGAWA N,EGAWA K,GRIFFIN H,et al.Human Papillomaviruses,Epithelial Tropisms,and the Development of Neoplasia Viruses[J].Viruses,2015,7(7):3863-3890.
[3]李秀,杨姗姗,安然.宫颈液基薄层细胞学检测(TCT)联合阴道镜在筛查宫颈病变中的价值[J].中国实验诊断学,2013,17(9):1644-1647.
[4]ABRAHAM J,STENGER M.COBAS HPV test for first-line screening for cervical cancer[J].J Community Support Oncol,2014,12(5):156-157.
[5]GROVES I J,COLEMAN N.Pathogenesis of human papillomavirus associated mucosal disease[J].J Pathol,2015,235(4):527-538.
[6]LAWSON H W.Practice Bulletin No.157:Cervical Cancer Screening and Prevention[J].Obstet Gynecol,2016,127(1):e1-e20.
[7]ZHANG L,LI Q,ZHAO M,et al.Discrepancies between biopsy-based and excision-based grading of cervical intraepithelial neoplasia:the important role of time between excision ang biopsy[J].Int Gynecol Pathol,2015,34(3):221-227.
[8]LU X,LIN M.Multiple-integrations of HPV16genome and altered transcription of viral oncogenes dan cellular genes are associated with the development of cervical cancer[J].PLoS One,2014,9(7):75-88.
[9]GUSTINUCCI D,GIORGI ROSSI P,CESARINI E,et al.Use of Cytology E6/E7 mRNA and p16INK4a-Ki-67to Define the Management of Human Papillomavirus(HPV)-Positive Women in Cervical Cancer Screening[J].Am J Clin Pathol,2016,145(1):35-45.
[10]赵琳琳.宫颈细胞HPV E6/E7mRNA检测在宫颈诊断价值中的分析[J].数理医药学杂志,2018,5(7):647-648.