Song Yinghui, Zhang Min, Zhang Cui, Du Shiyu, Zhai Furui
Department of Gynecology, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou 061000, Hebei, China.
Department of Gynecology, Cangzhou Central Hospital, No. 16 Xinhua West Road, Cangzhou 061000, Hebei, China.
Diagn Microbiol Infect Dis. 2024 Jan;108(1):116119. doi: 10.1016/j.diagmicrobio.2023.116119. Epub 2023 Oct 21.
To evaluate the diagnostic value of combining HPV E6/E7 mRNA testing with Thin-Prep cytology (TCT) for residual/recurrence detection, a total of 289 patients who underwent loop electrosurgical excision procedure (LEEP) for high-grade cervical lesions were included. Patients were followed up at different time points, and residual/recurrent lesions were confirmed through vaginoscopy. TCT, HPV-DNA, and HPV E6/E7 mRNA tests were conducted. Diagnostic performance, including sensitivity, specificity, positive predictive value, negative predictive value, and accuracy, was assessed. Among the patients, 76 cases showed residual lesions/recurrence, while 213 cases showed no residual/recurrence. Positive margins in the cervical-vaginal and cervical canal areas were associated with a higher risk of residual/recurrence. The combined HPV E6/E7 mRNA and TCT test showed higher diagnostic efficacy than individual tests at 6-, 12-, and 24-months follow-up. The combined test consistently demonstrated higher specificity and sensitivity, with significantly larger area under the curve (AUC) values compared to the individual tests.
为评估人乳头瘤病毒（HPV）E6/E7信使核糖核酸（mRNA）检测与薄层液基细胞学检测（TCT）联合用于残留/复发检测的诊断价值，研究纳入了289例因高级别宫颈病变接受环形电切术（LEEP）的患者。在不同时间点对患者进行随访，并通过阴道镜检查确认残留/复发病变。进行了TCT、HPV-DNA和HPV E6/E7 mRNA检测。评估了包括灵敏度、特异度、阳性预测值、阴性预测值和准确度在内的诊断性能。患者中，76例出现残留病变/复发，213例未出现残留/复发。宫颈-阴道和宫颈管区域切缘阳性与残留/复发风险较高相关。在6个月、12个月和24个月随访时，HPV E6/E7 mRNA与TCT联合检测显示出比单独检测更高的诊断效能。联合检测始终显示出更高的特异度和灵敏度，与单独检测相比，曲线下面积（AUC）值显著更大。
