【摘要】 目的探讨高危型人乳头瘤病毒(HR-HPV)E6/E7 m RNA及HPV DNA检测与宫颈病变的关系。方法选取2013年1月至2015年12月在青岛市市立医院妇科门诊行宫颈癌联合筛查的两组女性:LCT+HRHPV DNA(HC2组,n=2 417);LCT+HR-HPV E6/E7 m RNA(E6/E7组,n=2 906)。细胞学ASCUS+或HPV阳性转诊阴道镜行宫颈活检。计算HPV m RNA E6/E7与HPV DNA在不同病理结果中的阳性率、病毒载量及在CIN2+中的一致率。结果 (1)在病理正常、CIN1、CIN2、CIN3和ICC中E6/E7 m RNA阳性率分别为61.36%、76.00%、92.11%、96.00%和100.00%,随病变程度加重而升高(P<0.05)。正常病理结果中E6/E7组HPV的阳性率低于HC2组(χ2=7.764,P=0.005)。(2)E6/E7组病毒载量的中位数和四分位数在不同病理结果中分别为629.72(339.31,2 122.94),1117.33(319.17,3 101.88),1 537.12(422.19,4 219.05),3 396.59(1 217.32,6 316.81),10 860.43(3 473.19,29 662.29),随着病变程度加重逐渐升高,差异有统计学意义(P<0.05)。(3)在CIN2+患者中,E6/E7组和HC2组的一致率为82.64%,Kappa值=0.69。结论 HPV E6/E7阳性率与HC2一样随着宫颈病变程度的加重逐渐升高。HPVE6/E7 m RNA与HPV DNA诊断CIN2+的一致性较好。HPV E6/E7载量可能反映病变程度,但还需进一步临床验证。更多还原

【Abstract】 Objective To explore the relationship between high risk human papilloma virus(HR-HPV) E6/E7 m RNA and human papilloma virus(HPV) DNA with the degree of cervical lesions. Methods Data of women with cervical lesions screening in Qingdao Municipal Hospital gynecology from January 2013 to December 2015 were collected. The screening method of group 1(HC2 group,n=2 417) was LCT+HC2, and group 2 was LCT+E6/E7(E6/E7 group,n=2 906). The criterion of colposcopy referral was ASCUS+ or HPV+. The numbers of biopsy in HC2 group and E6/E7 group were 512 and 567 respectively. The HPV positive rates and viral loads in all pathologic results, the Kappa values of E6/E7 with HC2 in CIN2+ were calculated. Results The E6/E7 positive rates in normal pathologic group, CIN1, CIN2, CIN3 and ICC group were 61.36%, 76.00%, 92.11%, 96.00%, 100.00% respectively, increased with the aggravation of lesions(P<0.05). In normal pathologic group, the E6/E7 positive rate was lower than HC2 group(χ2=7.764,P=0.005). The m RNA loads were 629.72(339.31,2 122.94),1117.33(319.17,3 101.88),1 537.12(422.19,4 219.05),3 396.59(1 217.32,6 316.81),10 860.43(3 473.19,29 662.29) in normal biopsy group, CIN1, CIN2, CIN3 and the ICC group respectively, increased with the aggravation of lesions, with a statistically difference(Spearman r=0.56,P<0.05). In CIN2+, the consistency rate of E6/E7 and HC2 was 82.64% and the Kappa value was 0.69. Conclusion E6/E7 positive rates increased with the aggravation of lesions as HC2. The consistency between E6/E7 and HC2 in CIN2+ was good. More data should be collected to verify the consistency of E6/E7 loads with the degree of cervical lesions.更多还原