The Shunt Value Of HPV E6/E7mRNA Examination In Cervical Cytology ASCUS

Objective: To explore the shunt value of human papillomavirus(HPV)oncogene E6/E7 mRNA examination in patients with atypical squamous cell(ASCUS)whose cervical cytology results are of unknown significance.Methods : Collected from August 2019 to August 2020 at the Obstetrics and Gynecology Clinic of the First Affiliated Hospital of Beng Medical,and performed HPV DNA typing and HPV E6/E7 mRNA testing for patients whose liquid-based thin-layer cytology(TCT)results were ASCUS,Those with a positive result will undergo further colposcopy.The results of the two tests and the histopathological results of cervical biopsy were statistically analyzed to explore the shunt value of HPV E6/E7 mRNA detection in patients with ASCUS as TCT results.Results: 1.According to the pathological results of colposcopy cervical biopsy,231 ASCUS patients were divided into 117 cases of normal/chronic cervical inflammation(50.65%),65 cases of low-grade cervical intraepithelial lesions(28.14%),and 47 cases of high-grade cervical intraepithelial lesions(20.35%),and 2 cases of cervical cancer(0.87%).Among them,91 cases(39.39%)were positive for HPV E6/E7 mRNA test,and 127 cases(54.98%)were positive for HPV DNA test.There was no significant difference in the detection rate of CINII+ between them. 2.The specificity,sensitivity,negative predictive value,positive predictive value of HPV E6/E7 mRNA detection CINII+(ie HISL+SCC)were 69.2%,71.4%,90.0%,38.5%.While the HPV DNA test CINII+(ie HISL+SCC)were 53.3%,85.7%,93.3%,33.1%.The specificity of the former was significantly higher than the latter,and the difference was statistically significant(2=26.273,P<0.05);Comparing the sensitivity of them,the difference was not statistically significant.3.Count and analyze the virus mRNA copy number(copy/ml)in patients with cervical lesions of various grades.As the grade of the lesion increased,the COPY value also increases.The area under the ROC curve(AUC value)of the HPV E6/E7 mRNA test is0.69,which is higher than the HPV DNA value(0.60).The HPV E6/E7 mRNA test has a higher diagnostic efficiency than the HPV DNA test.Conclusion : 1.HPV E6/E7 mRNA test and HPV DNA typing test have no statistically significant difference in the detection rate of cervical lesions of various grades,and have the same clinical detection efficiency; 2.The specificity and positive predictive value of HPV E6/E7 mRNA testing for different grades of lesions are higher than HPV DNA testing,which improves the accuracy of screening,reduces the rate of missed diagnosis and misdiagnosis,and reduces the referral of colposcopy;3.The number of viral mRNA copies(copy/ml)in patients with various levels of cervical lesions.As the lesion level increases,the COPY value also increases.The level of expression and activity are positively correlated with the severity of cervical lesions.Potential high-level lesions can be detected as early as possible,while low-risk lesions can be excluded,combined with cytological examination to effectively divert ASC-US patients. 4.The sample size of this study is relatively limited,and a larger sample size is needed for further research and confirmation.