Study On The Application Of High-risk HPV E6/E7mRNA In Clinical Shunt Of ASCUS Patients

Objective:The paper aims at analyzing age,urban distribution,high-risk HPV DNA genotyping,high-risk HPV E6/E7mRNA test and histopathological examination results of colposcopy biopsy of ASCUS patients in order to study the risk factors affecting the pathological results of ASCUS patients and evaluate the application value of high-risk HPV E6/E7 mRNA detection method in the clinical shunt of ASCUS patients to guide clinical treatment.Methods:In this study,samples were offered by Lianyungang Maternal and Child Health Hospital from January 2017 to June 2019 with the cervical cytological examination results of ASCUS,acquired high-risk HPV DNA genotyping and high-risk HPV E6/E7 mRNA.The patients with biopsy pathological examination results by colposcopy were selected as the experimental subjects,among which 338 patients met the inclusion criteria.Age,urban distribution,high-risk HPV DNA typing,HPV E6/E7mRNA and pathological results of colposcopy were recorded in detail.The correlation between HPV E6/E7mRNA and pathological results of colposcopy was statistically analyzed by means of SPSS 21.0 software.Results:The histopathological results of colposcopy biopsy in 338 ASCUS patients were as follows:cervicitis accounted for 64.5%(218/338),LSIL(CINI)accounted for 15.09%(51/338)and HSIL and more serious lesions accounted for 20.41%(69/338).There was no significant difference in DNA typing of high risk HPV,high risk HPV E6/E7mRNA and pathological examination of colposcopy in 338 patients of different ages(20-29?30-39?40-49??50)(?2 was 4.882,5.528,10.784.P value was 0.181,0.137,0.095 respectively).There was no significant difference in the results of women from different urban areas(urban areas,county areas)(x2 was 3.697,0.002 and 0.408respectively;P value was 0.055,0.964 and 0.523 respectively).There was no significant difference in the number of high-risk HPV E6/E7mRNA and colposcopy pathological examination results among ASCUS patients with positive HPV DNA detection(?2 was 0.142,2.586,P=0.923,0.274).According to the gold standard of colposcopy pathology,the rate of high risk HPV E6/E7mRNA positive in normal group,LSIL group and ?HSIL group increased gradually(19.27%,68.72%,92.75%).The results were statistically significant(?2=134.303,P=0.000),the positive rate of ?HSIL group was significantly higher than that of LSIL group(P<0.01),and the positive rate of LSIL group was higher than that of normal group(P<0.01);the positive rate of high-risk HPV DNA typing in normal group,LSIL group and ?HSIL group also increased gradually(58.72%,78.43%,92.75%).The results were statistically significant(?2=30.885,P=0.000).In addition,the positive rate of ?HSIL group was significantly higher than that of LSIL group(P<0.01),and the positive rate of LSIL group was higher than that of normal group(P<0.01).The sensitivity and the specificity of HPVE6/E7mRNA in colposcopy?HSIL group were 92.25%and 71.37%,the positive and negative predictive values were 45.39%and 97.46%,the sensitivity and the specificity of HPV DNA typing in colposcopy ?HSIL group were 94.20%and 37.55%,the positive and negative predictive values were 27.90%and 96.19%.And further analysis through the receiver operating characteristic curve(ROC)showed that AUC of high risk HPV E6/E7mRNA was larger,which was 0.925(95%CI,0.888-0.962).The positive rate of HPVE6/E7mRNA was 36.3%in 233 cases with positive HPV DNA.Compared with the positive rate of HPV E6/E7mRNA(95.4%)in?HSIL group,with(?2=65.63,P<0.01),the difference was statistically significant(?2=65.63,P<0.01).Conclusion:1.The pathological results of colposcopy in ASCUS patients are characterized by diversity,which consist of inflammation,LSIL,HSIL and cervical cancer.2.The age and the urban distribution of ASCUS patients were not correlated with the detection of HPV DNA,HPV E6/E7mRNA and the pathological results of colposcopy.3.HPVE6/E7mRNA detection and colposcopy pathological results are not related to the number of infection types.4.The detection rates of HPV E6/E7mRNA positive in different cervical lesions of ASCUS patients were different,with the highest rate in(?)HSIL group.Compared with high-risk HPV typing,high-risk HPV E6/E7mRNA detection can accurately diagnose(?)HSIL lesions in ASCUS patients,which can be used as a better detection method to guide the next diagnosis and treatment of ASCUS patients.5.The detection rate of positive patients in need of treatment can be increased,and some colposcopy referrals can be reduced by increasing the detection rate of HPV E6/E7mRNA in ASCUS patients after the shunt of HP V DNA detection.