Pruski Dominik, Millert-Kalinska Sonja, Lewek Anna, Kedzia Witold
Division of Gynecology, Department of Perinatology and Gynecology, Gynecology and Obstetrics Clinical Hospital, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
Laboratory of Cervical Pathophysiology, Gynecology and Obstetrics Clinical Hospital, Karol Marcinkowski University of Medical Sciences, Poznan, Poland.
Ginekol Pol. 2019;90(2):66-71. doi: 10.5603/GP.2019.0011.
The paper assess the relevance of HR HPV E6/E7 mRNA test in women with abnormal Pap results.
Between 2013-2014, 125 women were subjects to the enhanced diagnostics due to abnormal Pap results. According to The Bethesda system, if ASC-US, AGC, LSIL, ASC-H, HSIL or cancer cells were present, the result was abnormal. The patients underwent the enhanced diagnostics which included the following procedures: Pap smear collection for molecular assessment of HR HPV E6/E7 mRNA test, the colposcopic examination and biopsy of clinically suspicious areas.
High-grade squamous intraepithelial lesions constituted the most frequent cervical pathology in women with abnormal Pap test results, as well as with the positive results of HR HPV E6/E7 mRNA test. Test sensitivity in patients with the histopathological diagnosis of high-grade squamous intraepithelial lesion was estimated at 86.1%.
HR HPV E6/E7 mRNA test identifying neoplastic lesions and cervical cancer is characterised by a high relevance which is reflected by means of sensitivity and specificity. In fact, test sensitivity and specificity increased with the age in the group of patients up to 50 years old.
本文评估高危型人乳头瘤病毒E6/E7 mRNA检测在巴氏涂片结果异常女性中的相关性。
2013年至2014年间,125名因巴氏涂片结果异常而接受强化诊断的女性。根据贝塞斯达系统,如果存在非典型鳞状细胞意义不明确(ASC-US)、非典型腺细胞(AGC)、低度鳞状上皮内病变(LSIL)、非典型鳞状细胞不排除高度病变(ASC-H)、高度鳞状上皮内病变(HSIL)或癌细胞,则结果为异常。患者接受了强化诊断,包括以下程序:采集巴氏涂片用于高危型人乳头瘤病毒E6/E7 mRNA检测的分子评估、阴道镜检查以及对临床可疑区域进行活检。
高度鳞状上皮内病变是巴氏涂片检测结果异常以及高危型人乳头瘤病毒E6/E7 mRNA检测结果呈阳性的女性中最常见的宫颈病变。经组织病理学诊断为高度鳞状上皮内病变的患者的检测敏感性估计为86.1%。
高危型人乳头瘤病毒E6/E7 mRNA检测在识别肿瘤病变和宫颈癌方面具有高度相关性,这通过敏感性和特异性得以体现。事实上,在50岁及以下的患者组中,检测的敏感性和特异性随年龄增长而增加。