Clinical Significance Of Human Papillomavirus E6/E7mRNA Test For Cervical Lesions’s Hierarchy Management

Objective Explore the risk assessment efficiency and the clinical applicability of human papilloma virus(HPV)E6/E7 m RNA test for cervical lesions,Providing the basis for it’s hierarchical management.Methods From January 2016 to December 2016,a total of 148 subjects,treatment in Cervical Lesions’ Center of Ningxia Medical University,whose Liquid-based Cytology(TCT)Test result is equal or greater than atypical squamous cell of undetermined significance(≥ ASC-US),respectively received Hybrid Capture method(Hc2)HPVDNA detection and Quanti Virus TM HPVE6/E7 m RNA detection,With pathological biopsy as the gold standard,Comparison the positive rate and consistency of this two methods;Comparison the positive rate and expression level of HPVE6/E7 m RNA in different levels of cervical lesions;Evaluation the risk prediction value of HPVE6/E7 m RNA test in greater or equal to CINII ’s histological typeResult 1.Respectively compared the detection rate between HPV DNA and HPVE6E7 m RNA in different tissue types,The P values are 1.000,0.109,0.026,0.001,0.231,0.143.It can be concluded that the detection rate of HPVDNA was higher than HPVE6E7 m RNA in CINI and CINII,and other histological types’ difference was no statistical significant(P>0.05).In the HPV DNA and HPVE6E7 m RNA consistency checking,There are better consistency in chronic inflammation with koilocyte,CINI,CINII and invasive cervical cancer pathological types(Kappa values: 0.333、0.587、0.593)2.With the increase ofpathological level,HPV E6/E7 m RNA present a tendency of increasing positive rate and expression level,the difference was statistically significant(P<0.05);A further 22 pairwise expression level shows that invasive cancer expression was the highest,followed by CINIII and lowest expression of chronic cervicitis(P<0.05)3.The sensitivity of HPV E6/E7 m RNA detection and HPV DNA detection for diagnosis of greater or equal to CINII both are 86.7%,The specificity of HPVE6E7 m RNA 55.2% is higher than The specificity of HPV DNA 36.2%,But the difference was no statistical significant(P>0.05).Detection of HPV DNA detection and HPVE6E7 m RNA positive predictive value,negative predictive value respectively is 67.8%、 63.6%、 75.0%、 72.7%,the difference was no statistical significant(P>0.05),Through the areas of ROC for HPV E6/E7 m RNA and HPV DNA were 0.795 and 0.742 respectively,the accuracy of HPV E6/E7 m RNA was higher than the HPV DNA detection,and the difference was statistically significant(P<0.01).Conclusion 1.With the increase of cervical lesion’s pathological level,the positive rate and expression level of HPVE6E7 m RNA also increases.2.For the Liquid-based Cytology(TCT)test result equal or greater than atypical squamous cell of undetermined significance(≥ ASC-US)people,There are similar risk prediction value between HPV DNA and HPV E6E7 m RNA detection,and the better accuracy in HPVE6E7 m RNA detection,Provide the clinical evidence for hierarchical management of cervical lesions.