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-  2017 

高危型人乳头瘤病毒E6 / E7 mRNA与其DNA检测在子宫颈病变中的对比研究

Keywords: 宫颈上皮内病变,宫颈癌筛查,人乳头瘤病毒 ,

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目的?探讨高危型人乳头瘤病毒(HR-HPV) E6/E7 mRNA及HPV DNA检测与宫颈病变的关系。方法?选取2013年1月至2015年12月在青岛市市立医院妇科门诊行宫颈癌联合筛查的两组女性:LCT+HR-HPV DNA(HC2组,n=2 417);LCT+HR-HPV E6/E7 mRNA(E6/E7组,n=2 906)。细胞学ASCUS+或HPV阳性转诊阴道镜行宫颈活检。计算HPV mRNA E6/E7与HPV DNA在不同病理结果中的阳性率、病毒载量及在CIN2+中的一致率。结果?① 在病理正常、CIN1、CIN2、CIN3和ICC中E6/E7 mRNA阳性率分别为61.36%、76.00%、92.11%、96.00%和100.00%,随病变程度加重而升高(P<0.05)。正常病理结果中E6/E7组HPV的阳性率低于HC2组(χ2=7.764,P=0.005)。② E6/E7组病毒载量的中位数和四分位数在不同病理结果中分别为629.72(339.31,2122.94),1117.33(319.17,3101.88),1537.12(422.19,4219.05),3396.59(1217.32,6316.81),10860.43(3473.19,29662.29),随着病变程度加重逐渐升高,差异有统计学意义(P<0.05)。③ 在CIN2+患者中,E6/E7组和HC2组的一致率为82.64%,Kappa值=0.69。结论?HPV E6/E7 阳性率与HC2一样随着宫颈病变程度的加重逐渐升高。HPVE6/E7 mRNA与HPV DNA诊断CIN2+的一致性较好。HPV E6/E7载量可能反映病变程度,但还需进一步临床验证。

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