| Objective:This project aims to observe and analyze the precancerous lesions and the monitoring of cervical cancer by comparing the results of HPV DNA typing and HPV E6/E7mRNA quantitative detection in the patients.And To compare the sensitivity specificity of the two and the clinical value of early intervention in the prevention and treatment of cervical cancer.Methods:From December 2015 to December 2017,230 cases of women with cervical disease were chooseen from the affiliated hospital of the Youjiang national medical college.The total of 230 patients were diagnosed with TCT,HPV DNA and HPV E6/E7mRNA,156 of the patients underwent cervical biopsy.The results of histopathological examination were used as the gold standard for diagnosis.Aged between 21 and 74 years old,the average age was 37 years old,and had a sexual life history.Many patients were admitted to the hospital due to contact bleeding of cervical inflammation or lower abdominal pain.Non pregnancy,lactation and menstrual period,excluding immunosuppression,chronic disease,history of CIN,and uterus patients with a history of cervical cancer without the history of cervical conization or total hysterectomy and pelvic radiation therapy,all entrants signed informed consent.(1)TCT examination was performed by the pathology chamber and the results were judged according to the TBS grading system.(2006).(2)HPV-DNA type detection mainly adopts PCR combination of external amplification and DNA reverse dot hybridization,Virus copy number less than 1.0×104copies/mL is negative..(3)HPV E6/E7mRNA detection of cervical cancer virus plague gene E6 and E7 mRNA by cross capture and signal amplification.(4)Statistical methods were used to analyze data using SPSS20.0statistical software,and x~2 test was used to compare the data of each group,and P<0.05 was considered statistically significant.Result:(1)Of the 230 patients,HPV E6/E7 mRNA test 119 were positive.HPV DNA the positive patients were 190 cases.Cytological test results:NILM 139 cases;23 cases of ASCUS,ASCH 9 cases;LSIL 21 cases;HSIL 28 cases;10 cases of cervical cancer.Final histopathological examination 156.In that patients,113 cases were positive of HPV E6/E7mRNA and HPV DNA typing respectively 141 cases,the total positive rate was 72.4%and90.4%.There were 44 normal or inflammatory patients in pathological diagnosis,16 cases of grade CIN1,20 cases of CIN2,41 cases of CIN3,and 35 cases of cervical cancer.At the pathological level,the CIN1,CIN2,CIN3 and cervical cancer groups,the detection rate of HPVE6/E7mRNA was 43.8%,75.0%,87.8%,100.0%.With the increase of the severity of cervical lesions HPV E6/E7 mRNA detection.(2)Of the 190 cases of HPV positive,104 cases were single infection and 86 cases were multiple infection.Sixteen HPV subtypes were detected.The detection rate of HPV genotypes was in the order of high in turn::HPV16:35.8%(106/298),HPV52:31.2%(93/298),HPV58:23.8%(71/298),HPV51:12.1%(36/298),HPV18、33:9.4%(28/298),HPV68:8.7%(26/298),HPV31:7.4%(22/298),HPV43:6.7%(20/298),HPV56:6.4%(19/298),HPV39、42:5.4%(16/298),HPV59:5.0%(15/298),HPV11:4.0%(12/298),HPV53:3.0%(9/298),HPV81:2.3%(7/298).Among them,the rate of HPVl6 infection is the highest(35.8%)(3)The sensitivity of HPV E6/E7 mRNA detection and HPV DNA typing was 83.0%and90.2%,the difference was not statistically significant;the specificity of HPV E6/E7 mRNA was 54.5%,HPV DNA typing was 9.1%,and the difference was statistically significant,indicating that HPV E6/E7 mRNA detection was special.The difference was significantly higher than that of HPV DNA typing,and the positive predictive value of the two tests was82.3%,respectively71.6%,the difference was statistically significant.(4)The area under the ROC curve(AUC)of CIN+was 0.688 for HPV E6/E7 mRNA detection.The 95%confidence interval is(0.609~0.760).HPV DNA tests underneath the ROC curve of CIN+lesions.The product(AUC)is 0.504,95%confidence interval(0.423~0.585).By Z test,the difference is statistically significant(Z=3.733,P<0.001).In CIN+,HPV E6/E7mRNA detection in cervical addiction screening.The accuracy was higher than that of HPV DNA,but the diagnostic efficiency of both of them was poor.Conclusion:(1)HPV E6/E7 mRNA detection and HPV DNA classification test for diagnosis of cervical lesions.The specificity and positive predictive of HPV E6/E7 mRNA detection value are significantly higher.HPV E6/E7 mRNA detection positive patients are more likely to have cervical lesions.(2)For no cervix,HPV E6/E7 mRNA diagnostic coincidence rate of the lesions was higher than that of HPV DNA typing.(4)HPV E6/E7 mRNA detection is of great significance for the screening of cervical lesion. |
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