| Objective To study the application value of detection of E6/E7 mRNA of cervical exfoliated cells in early screening and HPV typing of cervical cancer. Methods A total of 268 patients with suspected cervical cancer admitted in Ankang Maternal and Child Health Care Hospital from March 2018 to March 2020 were randomly included as the study subjects,the cervical exfoliated cells were used as experimental samples to detect E6/E7 mRNA positive rate and copy number, and the HPV typing was checked.The incidence of cervical cancer was recorded with the pathological diagnosistaken as the gold standard of pathological diagnosis,268 patients were confirmed by pathological biopsy,140 patients included in the cervical cancer group,and 128 patients in the non cervical cancer group. Altogether 268 patients were classified into HPV types, including 212 high-risk HPV group and 15 low-risk HPV group and 41 low-risk mixed HPV group.The logistic regression was used to analyze the influencing factors of cervical cancer and high risk HPV,and the accuracy of all influencing factors to predict the cervical cancer and HPV typing was analyzed by receiver operator characteristic (ROC) analysis. Results The E6/E7 mRNA positive rate and copy number of cervical cancer patients group were higher than those of non cervical cancer patients groups,the E6/E7 mRNA positive rate and copy number of high risk HPV patients were higher than those of low-risk and low-risk mixed HPV patients,and the differences were statistically significant (P<0.05).The results of logistic multivariate analysis showed that the high risk factors of cervical cancer were education level of junior high school or below (95%CI: 0.187~0.836),pregnancy times≥3 times (95%CI:1.079~1.625),the first sexual life time<18 years (95%CI: 1.075~1.611),the squamous cell carcinoma antigen (SCC) (95%CI:1.058~1.782) and the HPV E6/E7 mRNA positive (95%CI:1.251~2.049) (P< 0.05).The Logistic multivariate analysis showed that the age (35~65 years old) (95%CI:1.134~1.436), pregnancy times≥3 times (95%CI:1.346~ 2.472),the sexual partners≥3 times (95%CI:1.526~2.386), abnormal vaginal secretion (95%CI:1.021~1.778), and HPV E6/E7 mRNA positive (95%CI:1.216~1.920) were independent risk factors for high-risk HPV (P<0.05).The ROC analysis showed that the AUC of multiple joint pre?diction probability of pregnancy, first sexual life time, SCC and HPV E6/E7 mRNA to predict the cervical cancer was 0.826, which was significantly higher than those of single detection (P<0.05).The AUC of age, pregnancy times, sexual partners, vaginal secretions and HPV E6/E7 mRNA combined prediction probability to predict the high risk HPV was 0.880, which was significantly higher than those of single detection (P <0.05).Conclusions The positive expression of HPV E6/E7 mRNA is an independent factor for cervical cancer and high-risk HPV. The combined monitoring based on HPV E6/E7 mRNA can significantly improve the accuracy of predicting cervical cancer and HPV typing compared with single detection. |
