Abstract: 【Abstract】 Objective To analyze and compare the clinical application value of human papilloma virus (HPV) DNA detection, HPV E6/E7 mRNA detection and thinprep cytologic test(TCT) in residual or recurrence of postoperative cervical intraepithelial neoplasia (CIN3+). Method A total of 530 patients with CIN3+ who underwent gynecological surgery in the Second People's Hospital of Yibin from April 2017 to August 2019 were selected as the research objects. The cases were followed up every 3 months aftersurgery for 4 times in total, and follow-up files were established. HPV DNA, HPV E6/E7 mRNA detection and TCT were used as follow-up monitoring indicators, and any abnormal indicators were referred to colposcopy for pathological diagnosis by biopsy and evaluated their follow-up value for postoperative residual or recurrence of lesions. Statistical methods were performed by t test or χ2 test. Result 530 CIN3+ patients who underwent cervical resection were followed up for 1 year, a total of 114 cases underwent colposcopy or biopsy, and a total of 18 cases were found to have residual lesions or recurrence, the ratio of residual lesions or recurrence was 5.7% (18/316). The negative rates of HPV E6/E7 mRNA at 3, 6, 9 and 12 months after surgery were 83.5% (264/316), 91.1% (288/316), 96.8% (306/316), 96.5% (305/316), respectively.The negative rates of TCT were 97.2% (307/316), 97.2% (307/316), 98.7% (312/316), 99.1% (313/316),respectively. The negative rates of HPV DNA were 53.2% (168/316), 72.8% (230/316), 81.0% (256/316),85.4% (270/316), respectively. The negative rates of HPV E6/E7 mRNA and HPV DNA showed a gradually increasing trend. The sensitivity [44.4% (8/18) vs 55.6% (10/18)] of HPV E6/E7 mRNA combined withTCT was lower than that of HPV DNA combined with TCT, but the specificity [94.8% (91/96)] and positivepredictive value [61.5% (8/13)] were higher than that of HPV DNA combined with TCT [89.6% (86/98) vs50.0% (10/20)] showed statistical significance (all P<0.05). Conclusion HPV E6/E7 mRNA combinedwith TCT detection has high specificity and positive predictive value for predicting CIN3+ or residual lesionsafter surgical treatment. It can be used to evaluate the prognosis of surgical treatment for high-grade cervical lesions, and detect patients with real risk of disease early. It can also help to avoid unnecessary excessive diagnosis and treatment, and reduce anxiety and stress of patients.
朱大华 陈家莲 胡洋 夏雪 赵雪 郭贝西 牟华平. HPV DNA 检测、HPV E6/E7 mRNA 检测和液基薄层细胞学检查对宫颈切除术后病灶残留或复发的预测价值[J]. 发育医学电子杂志, 2022, 10(3): 203-208.
Zhu Dahua, Chen Jialian, Hu Yang, et al. Predictive value of HPV DNA detection, HPV E6/E7 mRNA detection and thinprep cytologic test for residual or recurrent lesions after cervical resection. Journal of Developmental Medicine(Electronic Version), 2022, 10(3): 203-208.
2022, Vol. 10 
