Clinical Value Of Quantitative Detection Of Human Papillomavirus E6/E7 Mrna In Screening Of Cervical Intraepithelial Neoplasia

Objective:Collecting shedding cells by the cervical brush,to investigate the value of HPV E6/E7mRNA quantitative detection in cervical lesions screening,and compared with the HPV DNA examination,HPV E6/E7 mRNA examination,TCT examination through the pathological biopsy examination.Methods:From January 2014 to December 2015,a total of 553 patients who had abnormal cervical bleeding,vaginal discharge fluid or cervicitis,and visited to Sir Run Run Shaw hospital,all the patients received TCT test(prep Cytologic test TCT)by liquid protest system;Received high-risk HPV(HR-HPV)DNA detection by QuantiVirus?Received quantitative detection of HPV E6/E7 mRNA,the cervical pathology results as the gold standard for statistical analysis.evaluating the diagnostic efficiency of HPV E6/E7 mRNA to diagnose the CIN2+.Results:1.HPV E6/E7 mRNA positive detection rate:In cervical biopsy inflammatory or normal,CIN1,CIN 2,CIN3,ICC groups,the HPV mRNA positive rate is respectively 51.5%?76.19%?86.44%?92.30%?100%.While the Biopsy detection was CIN1 or normal,inflammation,HPV E6/E7mRNA detection positive rate was 54.90%,while the Biopsy detection was CIN2+,the detection of HPV E6/E7 mRNA positive rate was 86.17%.The sensitivity of HPV DNA determination of CIN2+ is 95.7%,while the sensitivity of HPV mRNA determination of CIN2+ is 89.4%.The specificity of HPV DNA detection is 26.1%,lower than the specificity of HPV mRNA(45.1%).2.The expression levels of HPV E6/E7 mRNA in different cervical lesions:In cervical biopsy inflammatory or normal,CIN1,CIN2 and CIN3,ICC groups,the expression of HPV E6/E7 mRNA is respectively 90.3(0.0?397.0),266.3(0.0?2241.3),1085.6(134.1?7394.5),1374.4(202.4?10458.8),2343.7(443.8?24947.7).3.The best diagnostic critical point of CIN2+ with HPV E6/E7 mRNA is 298copies/ml,and the area under the ROC was 0.786,and the sensitivity HPV E6/E7 mRNA(?298 copies/mL)to the diagnosis of CIN2+ was 76.6%,while the specificity was 68.9%.4.Correlation between HPV E6/E7mRNA distribution and pathologic biopsy CIN2+:HPV subtypes 58,52,18,16 appear high frequency.In these four subtypes,positive expression rate of HPV E6 and E7 mRNA was respectively 81.82%,63.64%,69.23%,84.09%.The positive predictive value was 66.67%?71.43%?77.78%?83.78%respectively.The missed diagnosis rate was 20%,28.57%,12.50%,6.06%respectively.Conclusion:1.The positive rate of HPV E6/E7 mRNA increased with the increase of the severity of pathological examination,the diagnostic efficacy of HPV E6/E7 mRNA in the diagnosis of CIN2+ was higher than that of CIN1-.2.The specificity of HPV E6/E7 mRNA for CIN2+ diagnosis was better than that of HPV DNA detection.3.When HPV E6/E7 mRNA detection combined with HPV DNA typing detection,the positive detection value of HPV 16 subtype and HPV 18 subtype to detect CIN2+ is high,fewer missed diagnosis.