| Objective:In this study,HPV typing and HPV E6/E7 mRNA were compared with the accuracy,sensitivity,specificity,positive predictive value,negative predictive value and other indicators of HPV typing and HPV E6/E7 mRNA in liquid-based cytology positive patients.The value of screening in patients with positive liquid-based cytology.Method:From October 2018 to October 2019,146 women who underwent cervical cancer screening and colposcopy cervical biopsy in the gynecological clinic of Bethune First Hospital of Jilin University from October 2018 to October 2019(with no history of cervical lesions and cervical surgery).Analyze the distribution characteristics of HPV subtypes;use pathological diagnosis as the gold standard to analyze the accuracy,sensitivity,specificity,negative predictive value,positive predictive value and the AUC value of the area under the characteristic curve(Receiver operating characteristic curve,ROC)of HPV DNA typing and HPV E6 / E7 mRNA.Results:1.Among the 146 patients,132 were HPV-positive patients,and the positive rate of HPV typing was as high as 90.4%,and 21 HPV genotypes were detected.The distribution frequency of HPV genotypes in descending order is: HPV16: 16.3%(34/208),HPV52: 10.1%(21/208),HPV58: 10.1%(21/208),HPV33: 8.2%(17/208),HPV53: 6.7%(14/208),HPV18: 6.3%(13/208),HPV66: 5.3%(11/208),HPV51:4.8%(10/208),HPV56: 4.3%(9/208),HPV39: 3.8%(8/208),HPV31: 3.4%(7/208),HPV6: 3.4%(7/208),HPV59: 2.9%(6/208),HPV81: 2.9%(6/208).2.The TCT results of 146 positive cytology patients were 49 cases of ASCUS,39 cases of LISL,22 cases of ASC-H,and 36 cases of HSIL.The positive rates of HPV E6/E7 mRNA in ASCUS,LISL,ASC-H,and HSIL were 59.1%,69.2%,77.3%,and 83.3%,respectively.The positive rates of HPV E6/E7 mRNA in different cytology showed a gradual upward trend.The difference was statistically significant(χ2=6.278,P=0.012).The positive rates of HPV typing in ASCUS,LISL,ASC-H,and HSIL were 85.7%,92.3%,90.9%,and 94.4%,respectively.There was no significant difference in the positive rates of HPV typing in different cytology(χ2=1.609,P=0.205).3.The 146 cytology-positive patients were divided into groups according to the level of pathological examination results: chronic cervicitis(67 cases),CIN1(40cases),CIN2-3(34 cases)and cervical cancer(5 cases).The positive rates of HPV E6/E7 mRNA in the above four groups were 58.2%,75.0%,85.3%,and 100%,respectively.The positive rates of HPV E6/E7 mRNA in different histology showed a gradual upward trend,and the difference was statistically significant(χ2= 10.722,P=0.001).The positive rates of HPV typing in the above four groups were 89.6%,92.5%,88.2%,and 100%,respectively.There was no statistically significant difference in the positive rates of HPV typing in different histologies(χ2 = 0.062,P =0.804).4.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of HPV E6/E7 mRNA for the diagnosis of CIN2+ were 49.3%,87.2%,35.5%,33.0%,and 88.4%,respectively.The accuracy,sensitivity,specificity,positive predictive value,and negative predictive value of HPV typing for the diagnosis of CIN2+ were 30.8%,89.7%,9.3%,26.5%,and 71.4%,respectively.The accuracy,sensitivity,specificity,positive predictive value and negative predictive value of HPV16/18 for the diagnosis of CIN2+ were 61.0%,35.9%,70.1%,30.4%,75.0%,respectively.The area of the curve under the HPV E6/E7 mRNA detection is0.61,and the 95% confidence interval is 0.516-0.711;the area under the curve for the HPV DNA detection method is 0.50,and the 95% confidence interval is 0.389-0.602.5.Forty patients diagnosed with LSIL in pathological biopsy were followed up.After 12 months of follow-up,the progress rate of HPV E6/E7 mRNA positive group was 30.00%,and that of HPV E6/E7 mRNA negative group was 00.00%.The progression rate of HPV E6/E7 mRNA positive group was higher than that of negative group.Conclusion:1.At the cytological level,as the level of cytology increases,the positive rate of HPV E6/E7 mRNA increases;at the histological level,as the level of pathology increases,the positive rate of HPV E6/E7 mRNA increases.2.The accuracy,specificity,and negative predictive value of HPV E6/E7 mRNA detection are significantly higher than that of HPV typing,but there is no difference in the sensitivity of the two.The AUC value of HPV E6/E7 mRNA detection is greater than the AUC value of HPV typing.3.When triage ASCUS and above patients,HPV E6/E7 mRNA detection is more valuable than HPV typing.4.The progression rate of HPV E6/E7 mRNA-positive patients in LSIL patients is higher than that of HPV E6/E7 mRNA-negative patients. |
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