| objective To research the application value of high risky type of human papillomavirus gene E6/E7 m RNA in cervical lesions.method The object of the study were 350 patients who have performed TCT. They were divided into 5 groups,including 194 in NIML, 50 in ASCUS,61 in HSIL and 5 in SCC.HR-HPV classification test and HPV E6/E7 m RNA test were performed in all the patients, respectively. Colposcopy pathological biopsy were chosen as the standard detection procedure in order to compare the difference of positive rates, sensitivity and specificity as well as the relativity between the two test methods in cervical lesions.result 1. All the 350 patients were performed by colposcopy pathological biopsy, of which the cases of uterine cervicitis, cervical neoplasia of epithelial cells and squamous cell carcinoma of cervix were 220,119 and 11, respectively. All the patients were performed by HR-HPV DNA typing test, and the result showed that the most popular HR-HPV in the region were the type of 16, 58, 52, 18, 31, 33, 39(21.21%, 16.16%, 12.63%, 9.60%, 5.56%, 4.04% and3.54% respectively). 2. The positive rates of E6/E7 m RNA in CINⅠ,CIN Ⅱ,CIN and cervical carcinoma Ⅲgroups were 58.18(%),90.24(%),95.65(%) and 100(%), respectively, and there were statistical significance between each group which shown the positive ratios of E6/E7 m RNA increase as the extent of pathological. The positive rates of HR-HPVDNAin CINⅠ,CIN Ⅱ,CIN Ⅲand cervical carcinoma groups were 80.00(%),87.80(%),91.30(%) and 100(%), respectively, and there were statistical significance between each group which presented that the positive ratios of HR-HPVDNA increase as the grade of pathological. There were no statistical significance between the positive rates of E6/E7 m RNA and HR-HPVDNA in each groups which shown that E6/E7 m RNA test is a reliable method in screening CIN and cervical carcinoma, and has good correlation with cervical lesions. 3. There were 86 cases with HR-HPVDNA among 220 cervicitis, including 36 cases with E6/E7 m RNA and 50 cases without E6/E7 m RNA, and there were statistical significance which shown that the indicator of E6/E7 m RNA can calculate and evaluate the risk of cervical carcinoma. 4. The sensitivity of E6/E7 m RNA and HR-HPVDNA in CIN and cervical carcinoma detected were 78.46(%)(102/130) and 86.15(%)(112/130),respectively.There were no statistical significance between the two value(P﹥0.05). The specificity of E6/E7 m RNA and HR-HPVDNA in CIN and cervical carcinoma were 83.64(%)(184/220) and 60.91(%)(134/220).There were statistical significance between the two value(P﹤0.05).The positive predictive value of HR-HPVDNA test and E6/E7 m RNA in CIN and cervical carcinoma were 56.57(%)(112/198) and 73.91(%)(102/138),individually There were statistical significance between the two value(P ﹤ 0.05).The negative predictive value of E6/E7 m RNA and HR-HPVDNA in CIN and cervical carcinoma were 86.79(%)(184/212) 88.16(%)(134/152),separately. There were no statistical significance between the two value. 5. There were 102 cases with CIN and cervical carcinoma among patients with E6/E7 m RNA by pathological biopsy. There were 110 cases with CIN and cervical carcinoma among patients with positive results of TCT by pathological biopsy.There were 123 cases with CIN and cervical carcinoma among patients with E6/E7 m RNA and positive results of TCT by pathological biopsy, and there were statistical significancebetween the three values. E6/E7 m RNA test assioated with TCT can reduce the rate of missed diagnosis.Conclusion 1. The sensitivity of HPVE6/E7 m RNA test and HR-HPVDNA test for detecting CIN and cervical carcinoma were similar, and the specificity of HR-HPVE6/E7 m RNA test was higher than HR-HPVDNA test. Since E6/E7 m RNA was a kind of oncogene, it can be used as an indicator to evaluate the risk among patients with HR-HPVDNA and positive results of TCT. 2. E6 / E7 m RNA has a stronger correlation with cervical cancer and is a high specificity indicator for judging women who was suffering from cervical cancer. 3.Among all the lab tests for screenning cervical cancer, HR-HPVE6/E7 m RNA test can act as additional role to make up HR-HPVDNA test with TCT. Besides, HR-HPVE6/E7 m RNA test with TCT can reduce missed diagnosis rate of cervical cancer. According to the results of HR-HPVE6/E7 m RNA test with colposcope test, we can cho ose different the rapeutic regimen for patients. |
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