Department of Pathology and Medicine, Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, CA 94304, USA.
Gynecol Oncol. 2011 Jan;120(1):89-93. doi: 10.1016/j.ygyno.2010.09.013. Epub 2010 Oct 14.
Current methods for HPV screening rely on the detection of L1 DNA from high risk genotypes (HRHPV). These assays have very high negative predictive values (~99%), however, the specificity and positive predictive value of HPV DNA tests for pre-cancerous and cancerous lesions (CIN 2+) is less than 50%. The purpose of this study was to compare HPV DNA with intracellular HPV E6, E7 mRNA quantification in an effort to improve the performance of cervical cancer screening.
Liquid-based cervical cytology specimens collected in either PreservCyt or SurePath were processed for routing cytology, HPV HRDNA detection by Hybrid Capture 2 and HPV E6, E7 mRNA quantification in cells using the same sample. We analyzed a total of 2049 samples including 73 with CIN 2, CIN 3, or squamous cell carcinoma by biopsy and 1694 samples from women with normal cytology.
The positive predictive value of HPV E6, E7 mRNA quantification in cells for CIN2+ was 78% which was greater than HPV DNA alone (43%). The specificity of HPV E6, E7 mRNA quantification was 96% based on normal cytology compared to 82% for HC2 while the specificity of HPV E6, E7 mRNA quantification based on CIN 2- histology was 85% compared to 35% for HC2.
With similar sensitivity and greater specificity/positive predictive value, HPV E6, E7 mRNA quantification in cells is an improvement over HPV DNA for cervical cancer screening.
目前的 HPV 筛查方法依赖于高危基因型（HRHPV）L1 DNA 的检测。这些检测方法具有非常高的阴性预测值（~99%），然而，HPV DNA 检测对癌前病变和癌症病变（CIN2+）的特异性和阳性预测值小于 50%。本研究的目的是比较 HPV DNA 与细胞内 HPV E6、E7 mRNA 定量，以提高宫颈癌筛查的性能。
使用 PreservCyt 或 SurePath 收集的液基宫颈细胞学标本，用于常规细胞学、Hybrid Capture 2 检测 HRHPV DNA 和使用相同样本检测细胞内 HPV E6、E7 mRNA 定量。我们分析了总共 2049 个样本，包括 73 个活检为 CIN2、CIN3 或鳞状细胞癌的样本和 1694 个细胞学正常的样本。
细胞内 HPV E6、E7 mRNA 定量对 CIN2+的阳性预测值为 78%，高于 HPV DNA 单独检测的 43%。基于正常细胞学，HPV E6、E7 mRNA 定量的特异性为 96%，而 HC2 为 82%，而基于 CIN2-组织学的 HPV E6、E7 mRNA 定量的特异性为 85%，而 HC2 为 35%。
细胞内 HPV E6、E7 mRNA 定量与 HPV DNA 相比具有相似的敏感性和更高的特异性/阳性预测值，是宫颈癌筛查的一种改进。
