论文部分内容阅读
目的探讨人乳头瘤病毒(HPV)E7蛋白检测宫颈病变的临床应用价值。方法选取180例高危型HPV阳性妇女,采用免疫细胞化学方法检测宫颈脱落细胞HPV E7蛋白。结果 (1)病理高级别宫颈上皮内病变(HSIL)及浸润癌组HPV E7蛋白阳性率(77.8%,56/72)显著高于低级别宫颈上皮内病变(LSIL)组(52.1%,25/48;P=0.003),病理LSIL组阳性率显著高于宫颈炎组(26.7%,16/60;P=0.007);(2)对于细胞学为ASCUS和LSIL的妇女,HPV E7蛋白诊断HSIL及宫颈癌的灵敏度、特异度、阳性预测值及阴性预测值分别为97.1%、52.1%、58.9%和96.2%;(3)HPV E7蛋白和TCT诊断LSIL及以上病变的灵敏度、特异度、阳性预测值、阴性预测值分别为67.5%vs 51.7%、73.3%vs 58.3%、83.5%vs 71.3%、53.0%vs 37.6%,除特异度外,E7蛋白诊断的价值优于TCT(P<0.05)。结论 HPV E7蛋白在检测宫颈病变,尤其是在细胞学轻度异常患者的分流中,具有一定的临床应用价值。
Objective To investigate the clinical value of human papillomavirus (HPV) E7 protein in detecting cervical lesions. Methods 180 cases of high-risk HPV-positive women were selected, and HPV E7 protein in cervical exfoliated cells was detected by immunocytochemistry. Results (1) The positive rates of HPV E7 protein in pathological high grade cervical intraepithelial neoplasia (HSIL) and invasive carcinoma (77.8%, 56/72) were significantly higher than those in low grade cervical intraepithelial lesion (LSIL) (52.1%, 25 / 48; P = 0.003). The positive rate of LSIL group was significantly higher than that of cervicitis group (26.7%, 16/60; P = 0.007). (2) For women with cytology ASCUS and LSIL, The sensitivity, specificity, positive predictive value and negative predictive value of cervical cancer were 97.1%, 52.1%, 58.9% and 96.2% respectively. (3) The sensitivity, specificity and positive predictive value of HPV E7 protein and TCT in the diagnosis of LSIL and above lesions The predicted value of E7 was 67.5% vs 51.7%, 73.3% vs 58.3%, 83.5% vs 71.3%, 53.0% vs 37.6%, respectively. The diagnostic value of E7 protein was better than that of TCT except for the specificity (P <0.05). Conclusion HPV E7 protein in the detection of cervical lesions, especially in mild cytology patients with shunt, has a certain clinical value.