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目的研究高危型人乳头瘤病毒(high-risk human papillomavirus,hrH PV)E 6/E 7 mRNA在结果意义不明的非典型鳞状上皮细胞(atypical squamous cells of undetermined significance,ASCUS)中的分流效率,探索其在ASCUS分流中的临床价值。方法选取2013年至2015年在青岛市立医院妇科门诊行细胞学筛查结果为ASCUS的女性405例,年龄21~65岁。根据HPV检测方法,分为3组:HC2组、HPV分型组、hrH PV E 6/E 7 mRNA(E6/E7)组。比较3种HPV检测方法分流ASCUS的灵敏度、特异度、阳性预测值、阴性预测值、阴道镜转诊率、CIN 2~+/CIN 3~+检出率。结果 (1)E 6/E 7分流ASCUS的CIN 2~+灵敏度为100.00%(90.51%~100.00%),CIN 2~+/CIN 3~+的特异度分别为64.84%(53.06%~75.99%)、56.46%(43.98%~69.72%),阴性预测值分别为100.00%(99.41%~100.00%)、100.00%(99.34%~100.00%),与HC2和HPV分型比较差异无统计学意义(P>0.05)。阳性预测值分别为40.79%(37.91%~44.29%)、15.79%(10.07%~20.94%),高于HC2(P<0.05)。阴道镜转诊率为47.80%,低于HC2和HPV分型(P<0.05)。CIN 2~+检出率为19.50%,高于HC2(P<0.05)。(2)E 6/E 7分流ASCUS检测CIN 2~+的曲线下面积为0.815,>HC2和HPV分型(P<0.05)。结论 hrH PV E 6/E 7mRNA分流ASCUS的灵敏度、特异度与HC2相似,PPV和CIN 2~+检出率更高,阴道镜转诊率更低,可用于ASCUS的分流。
Objective To study the shunt efficiency of high-risk human papillomavirus (hrH PV) E 6 / E 7 mRNA in atypical squamous cells of undetermined significance (ASCUS) To explore its clinical value in the shunt of ASCUS. Methods From 2013 to 2015, 405 women with ASCUS in gynecology outpatient department of Qingdao Municipal Hospital were enrolled, aged 21-65 years. According to the method of HPV detection, divided into 3 groups: HC2 group, HPV typing group, hrH PV E 6 / E7 mRNA group (E6 / E7). The sensitivity, specificity, positive predictive value, negative predictive value, colposcopy referral rate and CIN 2 ~ + / CIN 3 ~ + detection rate of three kinds of HPV detection methods were compared. Results CIN 2 + sensitivity of shunt ASCUS was 100.00% (90.51% -100.00%). The specificity of CIN 2 + / CIN 3 + was 64.84% (53.06% -75.99% ) And 56.46% (43.98% -69.72%) respectively. The negative predictive values were 100.00% (99.41% -100.00%) and 100.00% (99.34% -100.00%) respectively. There was no significant difference between HC2 and HPV genotype P> 0.05). The positive predictive value was 40.79% (37.91% ~ 44.29%), 15.79% (10.07% ~ 20.94%) higher than HC2 (P <0.05). The colposcopy referral rate was 47.80%, lower than that of HC2 and HPV (P <0.05). The detection rate of CIN 2 ~ + was 19.50%, higher than that of HC2 (P <0.05). (2) The area under the curve of ASC 6 ~ E 6 / E 7 shunt ASCUS for detecting CIN 2 ~ + was 0.815,> HC2 and HPV typing (P <0.05). Conclusion The sensitivity and specificity of hrH PV E 6 / E 7 shunt ASCUS are similar to those of HC2. The detection rates of PPV and CIN 2 ~ + are higher, and the colposcopy referral rate is lower, which can be used for shunting ASCUS.