The Application Value Of HPV E7 Oncoprotein Detection In The Trige Of Cervical Lesions

Objectives To give a preliminary evaluation for the value of hrHPV E7 oncoprotein detecting technology as a method on diagnosing cervical lesions.Method Choose 180 women who have indications(ASC or higher with hrHPV infection;infection with HPV 16/18)for colposcopy,brush their cervical exfoliated cells specimen for TCT and hrHPV E7 oncoprotein test(ICC)before colposcopy,carry out statistical analysis with pathologic results as the gold standard.Results 1.The postive rate of hrHPV E7 oncoprotein test increases along with cytological and pathologic grades,and the positive rate of abnormal cytology results groups(ASCUS,LSIL,HSIL)(70.1%,61/87)is obviously higher than that of normal cytology results group(38.7%,36/93)(?2=17.841,P<0.0001);the positive rate of ASCUS group(66.7%,46/69)is obviously higher than that of normal cytology results group(?2=12.386,P<0.0001).The positive rate of HSIL and cervical cancar group(77.8%,56/72)is obviously higher than that of LISL group(52.6%,25/48)(?2=8.667,P=0.003);the positive rate of LSIL group is obviously higher than that of cervicitis group(23.9%,16/60)(?2=7.315,P=0.007).2.Sensitivity,specificity,positive predictive value,negative predictive value of hrHPV E7 protein in the diagnosis of cervical lesions are all high,especially for women with mildly abnormal cytology cytology results,its sensitivity and negative predictive value in diagnosing HSIL and cervical cancers are very high.For women with ASCUS cytology results,the sensitivity,specificity,positive predictive value,negative predictive value of HPV E7 protein in the diagnosis of LSIL and more severe lesions are 81.3%,66.7%,84.8%,60.9%;the sensitivity,specificity,positive predictive value,negative predictive value in the diagnosis of HSIL and cervical cancers are 96.6%,55.0%,60.9%,95.7%.For women with ASCUS or LSIL cytology results,the sensitivity,specificity,positive predictive value,negative predictive value of HPV E7 protein in the diagnosis of LSIL and more severe lesions are 84.2%,68.0%,85.7%,65.4%;the sensitivity,specificity,positive predictive value,negative predictive value in the diagnosis of HSIL and cervical cancers are 97.1%,52.1%,58.9%,96.2%.3.The sensitivity,specificity,positive predictive value and negative predictive value of hrHPV E7 protein or TCT in the diagnosis of LSIL and more severe lesions are 67.5%versus 51.7%(x2=6.246,P<0.05),73.3%versus 58.3%(x2=4.130,P<0.05),83.5%versus 71.3%(x2=3.968,P<0.05),53.0%versus 37.6%(x2=4.192,P<0.05).The sensitivity,specificity,positive predictive value and negative predictive value of hrHPV E7 protein or TCT in the diagnosis of HSIL and cervical cancers are 77.8%versus 54.2%(?2=8.940,P<0.05),62.0%versus 55.6%(?2=0.963,P>0.05),57.8%versus 44.8%(x2=3.058,P>0.05),80.1%vs 64.5%(x2=5.734,P<0.05).The sensitivity and negative predictive value of hrHPV E7 protein in diagnosing cervical intraepithelial lesions or cervical cancer are slightly higher than that of TCT.Conclusion The postive rate of hrHPV E7 protein test increases along with cytological and pathologic grades,especially in the early stage of lesions,there is a significantly change in the postive rate of hrHPV E7 protein test.For high-risk HPV infected populations with mildly cytological abnormalities,the use of its further triage,can avoid many colposcopy referral of transient HPV infection and low-grade lesions,with no miss of high-level cervical intraepithelial lesions or cervical cancer(CIN2/3+).The sensitivity and negative predictive value of hrHPV E7 protein in diagnosing cervical intraepithelial lesions or cervical cancer are slightly higher than that of TCT.In summary:the preliminary study has shown that hrHPV E7 protein used in cervical lesions detecting have a certain clinical value,it is worth further study.