HPV E6/E7 mRNA与液基薄层细胞学联合检测在宫颈癌风险预测中的应用及探讨

Application and Exploration of Combined Detection of HPV E6/E7 mRNA and Thinprep Cytologic Test (TCT) in Predicting the Risk of Cervical Cancer

摘要: 目的：探讨人乳头状瘤病毒(HPV) E6/E7 mRNA与液基薄层细胞学检查(TCT)联合检测在宫颈癌风险预测中的应用价值。方法：选取2023年1月至2024年6月于延安市人民医院行宫颈癌和癌前病变筛查的216例患者作为研究对象，对其资料进行回顾性分析，该部分患者均同时行HPV E6/E7 mRNA与液基薄层细胞学检测联合及组织病理学检查，分析HPV E6/E7 mRNA与液基薄层细胞学单独检测及两者联合检测宫颈癌的灵敏性、特异性、阳性预测值及阴性预测值。结果：216例患者中，HPV E6/E7mRNA与液基薄层细胞学单独检测的敏感性、特异性、阳性预测值、阴性预测值分别为78.41%、42.50%、85.71%、30.91%和71.59%、62.50%、89.36%、33.33%；HPV E6/E7 mRNA与液基薄层细胞学联合检测的敏感性、特异性、阳性预测值、阴性预测值为93.19%、65.00%、92.13%、68.42%，差异均有统计学意义(P < 0.05)。结论：HPV E6/E7 mRNA和液基细胞学联合检测可有效提高宫颈癌及癌前病变的阳性检出率，敏感性和阴性预测值显著提升，与活检金标准的一致性较好，可有效判断HPV的感染状态和严重程度，减少不必要的阴道镜活检，减轻患者心理负担，对宫颈癌的风险预测有很好的应用价值。

Abstract: Purpose: To explore the application value of HPV E6/E7 mRNA and Thinprep cytologic test (TCT) in predicting the risk of cervical cancer. Methods: 216 patients who underwent HPV E6/E7 mRNA and TCT at Yan’an People’s Hospital from January 2023 to June 2024 were selected as the study subjects. The data were retrospectively analyzed. All patients underwent HPV E6/E7 mRNA combined with TCT and histopathological examination. The sensitivity, specificity, positive predictive value, and negative predictive value of HPV E6/E7 mRNA and TCT detected separately and combinedly for cervical cancer were analyzed. Results: Among 216 patients, the sensitivity, specificity, positive predictive value, and negative predictive value of HPV E6/E7 mRNA and TCT detected separately were 78.41%, 42.50%, 85.71%, 30.91% and 71.59%, 62.50%, 89.36% and 33.33%; The sensitivity, specificity, positive predictive value, and negative predictive value of combined detection of HPV E6/E7 mRNA and TCT were 93.19%,65.00%, 92.13%, and 68.42%, with statistically significant differences (P < 0.05). Conclusion: The combined detection of HPV E6/E7 mRNA and TCT can effectively improve the positive detection rate of cervical cancer and precancerous lesions, significantly increase sensitivity and negative predictive value, and have good consistency with the gold standard for biopsy. It can effectively determine the infection status and severity of HPV, reduce unnecessary colposcopy biopsy, reduce the psychological burden of patients, and have good application value in predicting the risk of cervical cancer.