Zhao Hua, Shao Huajiang
Medical School of Ningbo University, Ningbo Zhejiang 315000, China.
Department of Obstetrics & Gynecology, Yangming Hospital Affiliated to Medical School of Ningbo University, Yuyao Zhejiang 315400, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2016 Jun 28;41(6):606-11. doi: 10.11817/j.issn.1672-7347.2016.06.009.
To explore the diagnostic value of human papillomavirus E6/E7 mRNA for residue and recurrence of cervical intraepithelial neoplasia (CIN) patients after cervical conization.
A total of 154 patients, who underwent cervical conization and possessed complete follow-up data of high-grade cervical intraepithelial neoplasia (CINII, III), were subjected to thin-prep cytology test (TCT), HPV-DNA typing and HPV E6/E7 mRNA test in 3-6 months and 12 months after cervical conization. Abnormal cytology (≥ASC-US) or high-risk HPV-DNA (+) or HPV E6/E7 mRNA (+) cases were found by colposcopy and cervical biopsy pathological diagnosis.
Nine patients had residue and 22 recurred. HPV-DNA detections after cervical conization in 57 patients were positive. Among them, 30 patients had residual/recurrent lesions. HPV E6/E7 mRNA detections in 26 patients were positive. Among them, 24 patients had residual/recurrent lesions. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV-DNA were 96.8%, 78%, 52.6%, 99%, and 81.8%, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of diagnosis in the detection of HPV E6/E7 mRNA were 77.4%, 98.4%, 92.3%, 94.5%, and 94.2%, respectively. The specificity and positive predictive value of HPV E6/E7 mRNA test were greater than those of HPV-DNA typing test. There was a significant difference between the two groups (P<0.05).
Detection of HPV E6/E7 mRNA during the follow-up period could timely and effectively forecast the risk of residue and recurrence of CIN after cervical conization, and reduce excessive examination and treatment.
探讨人乳头瘤病毒E6/E7 mRNA对宫颈锥切术后宫颈上皮内瘤变（CIN）患者残留及复发的诊断价值。
选取154例行宫颈锥切术且拥有高级别宫颈上皮内瘤变（CINII、III）完整随访资料的患者，在宫颈锥切术后3 - 6个月及12个月进行薄层液基细胞学检测（TCT）、HPV-DNA分型及HPV E6/E7 mRNA检测。通过阴道镜及宫颈活检病理诊断发现细胞学异常（≥ASC-US）或高危HPV-DNA（+）或HPV E6/E7 mRNA（+）的病例。
9例有残留，22例复发。57例患者宫颈锥切术后HPV-DNA检测阳性，其中30例有残留/复发病变。26例患者HPV E6/E7 mRNA检测阳性，其中24例有残留/复发病变。HPV-DNA检测诊断的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为96.8%、78%、52.6%、99%和81.8%。HPV E6/E7 mRNA检测诊断的敏感性、特异性、阳性预测值、阴性预测值及准确性分别为77.4%、98.4%、92.3%、94.5%和94.2%。HPV E6/E7 mRNA检测的特异性和阳性预测值高于HPV-DNA分型检测。两组间差异有统计学意义（P<0.05）。
随访期间检测HPV E6/E7 mRNA可及时、有效地预测宫颈锥切术后CIN残留及复发风险，减少过度检查和治疗。
