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目的探讨高危型人乳头瘤病毒(HPV)E6/E7 mRNA检测在30岁以下年轻女性宫颈癌筛查及宫颈疾病诊治中的应用价值。方法选取30岁以下有性生活史3年以上妇科门诊行宫颈液基细胞学筛查(TCT)的ASCUS/LSIL患者226例,随机分为研究组和对照组各113例,对照组患者行高危型HPV DNA检测,研究组患者行HPV E6/E7 mRNA检测,阳性者行阴道镜+活检,CINⅡ以下分流管理,CINⅡ以上予以治疗。比较两组患者病变准确预测率、治疗费用、阴道镜转诊+活检率、患者满意度。结果研究组患者HPV E6/E7 m RNA检测阳性率为28.3%,低于对照组HPV DNA检测阳性率44.2%,CINⅡ以下患者HPV E6/E7 mRNA检测阳性率为13.3%,低于对照组HPV DNA检测阳性率28.3%,两组差异有统计学意义(P<0.05);≥CINⅡ患者HPV E6/E7 mRNA及HPV DNA检测阳性率分别为15.0%及16.9%,差异无统计学意义(P>0.05)。两组患者的总费用、阴道镜转诊+活检率、满意度差异有统计学意义(P<0.05)。结论 TCT联合高危型HPV E6/E7 mRNA检测比联合HPV DNA检测对病变准确预测率高,治疗费用低,阴道镜转诊+活检率低,患者满意度高。
Objective To investigate the value of detecting high-risk human papillomavirus (HPV) E6 / E7 mRNA in the diagnosis and treatment of cervical cancer in young women under 30 years of age. Methods A total of 226 ASCUS / LSIL patients with cervical cytology-based cytology (TCT) who had more than 3 years of sexual life under 30 years of age with sexual life history of more than 3 years were randomly divided into study group and control group with 113 cases each. Patients in the control group were at high risk Type HPV DNA test, the study group of patients with HPV E6 / E7 mRNA detection, positive colposcopy biopsy, CIN Ⅱ the following shunt management, CIN Ⅱ above to be treated. The accuracy of prediction of lesions in both groups was compared, treatment costs, colposcopy referral + biopsy rates, and patient satisfaction were compared. Results The positive rate of HPV E6 / E7 m RNA in the study group was 28.3%, which was lower than that of the control group (44.2%). The positive rate of HPV E6 / E7 mRNA in patients under CIN II was 13.3%, which was lower than that of the control group (P <0.05). The positive rates of HPV E6 / E7 mRNA and HPV DNA in patients with ≥INC Ⅱ were 15.0% and 16.9%, respectively, with no significant difference (P> 0.05 ). The total cost of two groups of patients, colposcopy referral + biopsy rate, the satisfaction difference was statistically significant (P <0.05). Conclusion TCT combined with high-risk HPV E6 / E7 mRNA detection than HPV DNA detection accuracy of the detection of the high rate of treatment, low cost, colposcopy referral + biopsy rate, patients with high satisfaction.