Clin Lab. 2020 Dec 1;66(12). doi: 10.7754/Clin.Lab.2020.200245.
To analyze the relationship between HPV infection and early cervical cancer and postoperative survival outcomes.
A total of 556 women were recruited to receive TCT and HPV tests from October 2017 to October 2018. The type of disease was pathologically diagnosed. The HPV positive rate, HPV-DNA, and E6/E7 mRNA quantitative level were detected, and the diagnostic accuracy of the subjects was analyzed by the receiver operating characteristic (ROC). The cervical intraepithelial neoplasia (CIN) and early cervical cancer patients were radically cured and followed up for 12.0 months to analyze the recurrence rate.
Seventy-two cases of chronic cervicitis, 54 cases of CIN, and 51 cases of cervical cancer patients were pathologically diagnosed (32 cases in early stage and 19 cases in middle and late stage). HPV positive rate increased gradually in chronic cervicitis, CIN, and cervical cancer group (p < 0.001) and HPV 16 + 18 subtype. The positive rate was significantly different (p = 0.009). HPV-DNA and E6/E7 mRNA quantification also showed significant differences (p < 0.001). ROC analysis indicated that the accuracy of HPV-DNA and E6/E7 mRNA quantitative diagnosis of malignant lesions (CIN+ cervical cancer) were 0.865 and 0.879, respectively. There were 4 cases (7.41%) of recurrence in CIN group and 5 cases (15.63%) in early cervical cancer group. There was no difference (p = 0.401) among all of the patients. All patients with recurrence were HPV positive.
HPV detection is an indispensable screening method for early cervical cancer and precancerous lesions, and comprehensive HPV 16 and 18 subtypes. DNA and E6/E7 mRNA quantification assay would further improve the accuracy of screening.
分析 HPV 感染与早期宫颈癌及术后生存结局的关系。
2017 年 10 月至 2018 年 10 月选取 556 例行 TCT 和 HPV 检查的女性，以病理诊断为疾病类型，检测 HPV 阳性率、HPV-DNA、E6/E7mRNA 定量水平，通过受试者工作特征曲线（ROC）分析其诊断准确率，对宫颈上皮内瘤变（CIN）及早期宫颈癌患者行根治术，并随访 12.0 个月，分析复发率。
病理诊断慢性宫颈炎 72 例、CIN 54 例、宫颈癌 51 例（早期 32 例、中晚期 19 例），HPV 阳性率在慢性宫颈炎、CIN、宫颈癌组逐渐升高（p<0.001），且 HPV16+18 亚型阳性率差异有统计学意义（p=0.009）。HPV-DNA、E6/E7mRNA 定量亦有显著差异（p<0.001）。ROC 分析提示 HPV-DNA、E6/E7mRNA 定量对恶性病变（CIN+宫颈癌）的诊断准确率分别为 0.865、0.879。CIN 组复发 4 例（7.41%），早期宫颈癌组复发 5 例（15.63%），差异无统计学意义（p=0.401），所有复发患者均为 HPV 阳性。
HPV 检测是早期宫颈癌及癌前病变筛查不可或缺的方法，综合 HPV16、18 亚型、DNA、E6/E7mRNA 定量检测可进一步提高筛查准确性。
