梁海燕??陈晓红

[摘要] 目的 评价高危HPVE6/E7mRNA在宫颈病变中的临床价值。 方法 将70例低度宫颈病变（慢性宫颈炎），子宫颈上皮内瘤变（CINI级）和78例高级别宫颈病变（包括CINⅡ级CINⅢ级和宫颈浸润性癌）分为两组。低度宫颈病变为对照组，高级别宫颈癌组为实验组。 分别进行HPV DNA分型和HPV E6/E7 mRNA检测。结果 低度子宫颈病变和高度子宫颈病变的阳性率分别为14.2%和79.5%。HPV DNA分型检测结果，低度子宫颈病变和高度子宫颈病变的阳性率分别为35.7%和85.7%。高风险HPV E6/E7 mRNA检测特异性，阳性预测值，阴性预测值（85.8%，86.1%，83.5%）显着高于（64.3%，70.5%，71.4%），差异有统计学意义。 结论 高危HPV E6/E7 mRNA检测有效降低了临床诊断中的过度检查和过度治疗的机会，避免了患者因高频重复感染引起的经济负担和精神压力。

[关键词] 人乳头瘤状病毒HPV；HPV DNA检测；HPV E6/E7检测；宫颈癌；方法对比

[中图分类号] R737.33 [文献标识码] A [文章编号] 2095-0616（2017）12-19-04

Comparative study of diagnostic value of HPV DNA and E6 / E7 mRNA detection in cervical lesions

LIANG Haiyan CHEN Xiaohong

Reproductive Medicine Center， the First Affiliated Hospital of Shantou University Medical College， Shantou 515031， China

[Abstract] Objective To evaluate the clinical value of high risk HPVE6/E7 mRNA in cervical lesions. Methods 70 patients with lower-grade cervical lesions （chronic cervicitis， cervical intraepithelial neoplasis， CINI-grade） and 78 patients with high-grade cervical lesions （including CINII grade， CINⅢ grade and cervical invasive carcinoma） were divided into two groups. Lower-grade cervical lesions were set as the control group while high-grade cervical lesions were set as the experimental group. They were respectively given HPV DNA typing and HPVE6/E7 mRNA detection. Results Detection of high risk HPVE6/E7 mRNA. Positive rates of lower-grade cervical lesions and high-grade cervical lesions were respectively 14.2% and 79.5%. Detection results of HPV DNA typing. Positive rates of lower-grade cervical lesions and high-grade cervical lesions were respectively 35.7% and 85.7%. Specificity， positive predictive value and negative predictive value of high risk HPVE6/E7 mRNA detection were respectively 85.8%， 86.1% and 83.5%， significantly higher than those 64.3%， 70.5% and 71.4%. Difference was statistically significant. Conclusion High-risk HPVE6/E7 mRNA detection can effectively reduce the chance of over-examination and over-treatment in clinical diagnosis and avoid the economic burden and mental stress caused by high-frequency repeated infection.

[Key words] Human papilloma virus HPV； HPV DNA detection； HPV E6/E7 detection； Cervical cancer； Method comparison

子宫颈癌是在宫颈阴道或移行带、子宫颈内膜的上皮交界處发生的恶性肿瘤[1]。世界卫生组织的统计显示，乳腺癌和子宫颈癌是两种主要疾病对女性健康的威胁，宫颈癌的发病率已跃居中国女性恶性肿瘤的第一位，发病趋势向年轻化发展，发病率逐年攀升[2]。对宫颈癌的病因研究结果发现，人乳头瘤病毒（HPV）是影响宫颈癌发生和发展的主要因素[3]。近年来，越来越多的HPV DNA检测方法已被用于检测宫颈病变，应用HPV DNA检测方法可以有效降低宫颈癌的发病率，但HPV DNA检测是检测原癌基因转录的其中一种手段，但其HPV活性是不可预测的[4]。另有研究指出，高危HPV E6/E7 mRNA检测手段可对病毒的活动程度和预测疾病的程度进行检测，更有利于宫颈癌病情的判断[5]。……