MicroRNA 联合TCT、HC2-HPV 检测高危人乳头瘤病毒对早期宫颈癌的诊断价值

Diagnostic value of microRNA combined with TCT, HC2-HPV and pathological analysis on early cervical cancer

摘要:

目的 分析microRNA 联合宫颈液基薄层细胞学检测（TCT）、二代杂交捕获法检测高危人乳头瘤 病毒（HC2-HPV）与病理学分析对早期宫颈癌诊断价值。方法 选取2016 年3 月-2017 年3 月于河南大学淮河 医院进行就诊的疑似宫颈癌患者150 例，根据病理学诊断结果分析TCT、HC2-HPV 及microRNA 检测的诊断 价值。结果 TCT 诊断结果[ 正常范围（NR）、意义不明的不典型鳞状细胞（ASCUS）、低度鳞状上皮内病变（LSIL）、 高度鳞状上皮内病变（HSIL）、鳞状细胞癌（SCC）] 与病理学结果[ 良性细胞改变（BCC），不典型增生轻度 （CIN-I），中度（CIN-II），重度（CIN-III），鳞状细胞癌（SCC）] 比较差异有统计学意义。TCT 诊断结果≥ ASCUS 有73 例呈阳性占48.67%（73/150），病理学结果≥ CIN-I 有79 例，占52.67%（79/150）。病理学诊断结 果（BCC，CIN-I，CIN-II，CIN-III 及SCC）与HC2-HPV 阳性率差异较大，且其随宫颈癌变严重程度逐渐升 高，差异有统计学意义（χ2=23.710，P =0.000）。病理学诊断结果与microRNA 相对表达量有关，MiRNA-21 与 MiRNA-193b 表达量随宫颈癌变严重程度逐渐升高；而MiRNA-124 与miRNA-195 表达量随宫颈癌变严重程 度逐渐降低。HC2-HPV 阳性率随宫颈癌变严重程度逐渐升高，差异有统计学意义（χ2=40.896，P =0.000）。 microRNA 联合TCT、HC2-HPV 检测的敏感性为98.73%，特异性为98.59%，诊断符合率为98.67%，均高于单 项microRNA、TCT、HC2-HPV 或者联合microRNA+TCT、HC2-HPV+TCT 及microRNA+HC2-HPV 的比较，差异有统计学意义（P <0.05）；此外，microRNA 的敏感性、特异性及诊断符合率优于单一TCT 及 HC2-HPV。结论 采用microRNA 联合TCT、HC2-HPV，用于早期宫颈癌患者的诊断，具有较高的敏感性、 特异性及诊断符合率。

Abstract:

Objective To analyze the diagnostic value of microRNA combined with TCT, HC2-HPV and pathology on early cervical cancer. Methods Totally 150 cases with suspected cervical cancer treated in our hospital from June 2014 to June 2015 were selected. The diagnostic value of TCT, HC2-HPV and micro RNA were analyzed based on pathological results. Results The diagnostic results of TCT (NR, ASCUS, ASCUS, LSIL, HSIL and SCC) were statistically different from those of pathology (BCC, CIN-I, CIN-II, CIN-III and SCC) (P < 0.05). There were 73 cases with TCT diagnosis results ≥ ASCUS accounted for 48.67% (73/150) and 79 cases with pathology ≥ CIN-I accounted for 52.67% (79/150). The results of pathological diagnosis (BCC, CIN-I, CIN-II, CIN-III and SCC) and HC2-HPV positive rate were significantly different, and the difference gradually increased with severity of cervical cancer (χ2 = 23.7108, P = 0.000). The relative expression of pathological diagnosis was significantly associated with the results of microRNA. The expression levels of miRNA-21 and miRNA-193b were gradually increased with the severity of cervical lesions; while the expression levels of MiRNA-124 and miRNA-195 were gradually decreased with the severity of cervical cancer. The positive rate of HC2-HPV was increased gradually with the severity of cervical cancer, which was significant different (χ2 = 40.896, P = 0.000). The sensitivity of micro RNA combined with TCT and HC2-HPV was 98.73%, the specificity was 98.59% and the diagnostic coincidence rate was 98.67%, which was significantly higher than that of microRNA, TCT or HC2-HPV only, respectively; or higher than microRNA combined with TCT, HC2-HPV combined with TCT or microRNA combined with HC2-HPV, respectively (P < 0.05). In addition, the sensitivity, specificity and diagnostic accuracy of microRNAs were better than those of single TCT or HC2-HPV. Conclusion MicroRNA combined with TCT and HC2-HPV can be used for diagnosis of early cervical cancer, which is of high sensitivity, specificity and diagnostic coincidence rate.