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目的分析人乳头瘤病毒(human papillomavirus,HPV)E 6/E 7 mRNA、第二代杂交捕获技术(hybrid Capture,HCⅡ)和薄层液基细胞学技术(thinprep cytology test,TCT)在宫颈上皮内瘤变(cervical intraepithelial neoplasia,CIN)筛查中的效能,选择适宜的分流筛查方案。方法采用病例-对照研究设计,80例CINⅠ~+的病例样本为HCⅡ或TCT筛查阳性并经组织学诊断;132例正常或炎症标本包括:组织学诊断正常或炎症的标本;HCⅡ阴性,TCT阴性且HPV E 6/E 7 mRNA均为阴性的标本。检测方法分别为:TCT进行细胞学检测、用b-DNA技术检测其HPV E 6/E 7 mRNA和用HCⅡ检测HPV DNA。结果在212例正常或宫颈炎和CIN标本中,HCⅡ的阳性率(37.74%)显著高于HPV E 6/E 7 mRNA的阳性率(25.94%)(P<0.05);与TCT的阳性率(31.60%)比较差异无统计学意义(P>0.05)。TCT的检出率高于HPV E 6/E 7mRNA的检出率,但差异无统计学意义(P>0.05)。HPV E 6/E 7 mRNA与HCⅡ的符合率最高,Kappa为0.733,P=0.000;其次为HC II和TCT的符合率,Kappa为0.564,P=0.000;HPV E 6/E 7 mRNA与TCT的符合率,Kappa仅为0.519,P=0.000。并且,在HCⅡ检测结果阳性的67例CINⅠ~+样本中,HPV E 6/E 7 mRNA检测或TCT检测结果皆为阳性。而在HCⅡ阳性的13例正常或炎症样本中,HPVE 6/E 7 mRNA+或TCT结果阳性仅有7例(53.85%)。结论在CINⅠ~+分流筛查方案中,HPV E 6/E 7 mRNA和TCT共同作为HCⅡ阳性分流筛查的方法,可有效降低HCⅡ的假阳性。
OBJECTIVE: To analyze the relationship between human papillomavirus (HPV) E 6 / E 7 mRNA, hybrid capture (HCⅡ) and thinprep cytology (TCT) Efficacy in screening of cervical intraepithelial neoplasia (CIN), select the appropriate shunt screening program. Methods A case-control study was designed. Eighty patients with CINⅠ ~ + were screened by HCⅡ or TCT and diagnosed by histology. The 132 normal or inflammatory specimens included histologically normal or inflammatory specimens, HCⅡ negative, TCT Negative and HPV E 6 / E 7 mRNA were negative specimens. The detection methods were as follows: TCT cytology, HPV E 6 / E 7 mRNA by b-DNA and HPV DNA by HCⅡ. Results The positive rate of HCⅡ (37.74%) was significantly higher than that of HPV E 6 / E 7 mRNA in 212 normal or cervicitis patients and CIN (25.94%) (P <0.05) 31.60%) was no significant difference (P> 0.05). The detection rate of TCT was higher than that of HPV E 6 / E 7 mRNA, but the difference was not statistically significant (P> 0.05). The coincidence rate of HPV E 6 / E 7 mRNA with HCⅡ was the highest, Kappa was 0.733, P = 0.000, followed by coincidence rate of HC II and TCT, Kappa was 0.564, P = 0.000; HPV E 6 / E 7 mRNA and TCT The coincidence rate, Kappa was only 0.519, P = 0.000. Moreover, HPV E 6 / E 7 mRNA or TCT results were positive in 67 CINⅠ ~ + samples with positive HCⅡ test results. However, there were only 7 (53.85%) positive cases of HPVE 6 / E 7 mRNA + or TCT in 13 normal or inflammatory HCⅡ-positive samples. Conclusion In the CIN Ⅰ ~ + shunt screening program, HPV E 6 / E 7 mRNA and TCT together as a positive screening method for HC Ⅱ can effectively reduce the false positive of HC Ⅱ.