Clinical Significance Of HPV E6/E7 MRNA Detection In Cervical Lesions Screening

Objective To investigate the clinical significance of HPV E6 / E7 m RNA detection in the screening and follow-up of cervical lesions.Methods3959 women were screened from opportunistic screening for Cervical Lesions in the outpatient and examination center of Qingdao Municipal Hospital from September 2009 to September 2015.The women who was 21-29 years old should accept LCT screening,if the results were ASCUS or above,accepted high risk HPV genotype and HPV E6 / E7 m RNA screening,when the results of HPV were abnormal should accept cervical biopsy under colposcopy.The women who were 30-65 years old accepted LCT and HPV genotype and HPV E6 / E7 m RNA detection.Whose LCT were ASCUS with abnormal HPV should accept cervical biopsy under colposcopy directly;whose LCT were NILM with abnormal HPV should be followed for one year,when the abnormal HPV were still persistent,the women should accept cervical biopsy under colposcopy.In the two age groups,whose results of biopsy were chronic cervicitis or CIN I should accept LCT and HPV genotype and HPV E6 /E7 m RNA detection again after 6 months,the women whose results were still abnormal accepted the secondary cervical biopsy under colposcopy.Results1.There were 95 cases in the 21-29 age group and 410 cases in the 30-65 age group who had accepted primary cervical biopsy.The specificity of CIN II + were 57.5%、51.1% and49.6% of HPV E6 / E7 m RNA detection in the first biopsy of women aged 21-29 and 30-65 years old,which were higher than HPV genotype detection(22.5%,28.9%,31.9%),the differences were statistically significant(2 = 20.417,P <0.05;2 = 19.342,P <0.05).The sensitivity of HPV genotype detection was higher than that of E6 / E7 m RNA detection(93.3%、89.9%、92.1%;80.0%、85.5%、86.8%),but the difference was not statistically significant(P=0.598;P=0.437;P=0.711).The positive predictive value of the two methods(18.4%、31.5%、31.3%;21.4%、38.8%、36.7%)were all low,the difference was not statistically significant(P=0.316;P=0.153;P=0.418).The difference in negative predictive value was not statistically significant(P=1.000;P=0.685;P=1.000).2.There were 21 cases in the 21-29 age group and 92 cases in the 30-65 age group who had accepted the secondary cervical biopsy.The specificity(62.5%、64.9%、66.7%),sensitivity(80.9%、90.5%、90.0%)and negative predictive value(90.1%、92.3%、94.1%)of HPV E6 / E7 m RNA detection when predicted CIN II+ were higher than those in HPV genotype detection(31.3%、40.5%、41.7%;60.0%、81.0%、80.0%;71.4%、78.9%、83.3%),but the difference was not statistically significant(P=0.156、0.062、0.147;P=1.000、0.663、1.000;P=0.528、0.424、0.552).When LCT was NILM with abnormal HPV,the positive predictive value of HPV genotype detection was higher than that of HPV E6/E7 m RNA detection(56.3%;52.9%),but the difference was not statistically significant(P=0.345).Conclusion1.The specificity of HPV E6 / E7 m RNA detection in the primary screening of cervical lesions was higher than the high-risk HPV genotype detection when predicted CIN II +,the difference of sensitivity was no significant.2.The specificity and sensitivity of the two detections were no significant difference when predected CIN II + in the follow-up whose results of the initial biopsy were chronic inflammation or CIN I.3.HPV E6 / E7 m RNA detection can be used as an adjunct method to cervical lesions screening.