RNA(E6和E7)筛查和DNA(E6和E7)筛查对妇女感染人乳头瘤病毒灵敏度的比较.doc

所属类别：临床方法学比较 杂志：Journal of clinical microbiology, July 2009,2136-2141 作者：Paola Cattani，Alessia Siddu, Sara D′Onghia, Simona Marchetti, Rosaria Santangelo, Valerio G. Vellone, Gian Franco Zannoni, Giovanni Fadda Title：RNA(E6 and E7) Assays versus DNA(E6 and E7) Assays for Risk Evaluation for Wowen Infected with Human Papillomavirus 题目：RNA(E6和E7)筛查和DNA(E6和E7)筛查对妇女感染人乳头瘤病毒灵敏度的比较 Abstract：In the majority of cases, high-risk human papillomavirus (HR HPV) infections regress spontaneously, with only a small percentage progressing to high-grade lesions. Current screening methods are based on DNA detection. An alternative would be to monitor expression of the E6 and E7 viral oncogenes continuously expressed by malignant phenotypes. In the work reported in this paper, we compared the two methods for a group of women with high-risk HPV infections. Cervical specimens from 400 women, previously found to be HPV DNA positive, were analyzed for HPV DNA by a liquid hybridization assay and typed by multiplex PCR (for types 16, 18, 31, and 33). Identification of HR HPV E6 and E7 RNA transcripts was performed using real-time reverse transcription-PCR and nucleic acid sequence-based amplification assays. Results were compared with concurrent cytological data. HR HPVs were found in 61.2% of patients. The most common genotype was HPV type 16 (HPV-16) (47.1%), followed by HPV-18, HPV-31, and HPV-33. Nine percent of cases involved other genotypes. Among 223 HPV DNA-positive samples, only 118 were positive in the RNA test. Among HPV DNA-positive patients with normal cytology, we detected E6 and E7 RNA transcripts in two cases (18.2%). The rate of detection increased gradually with the grade of the observed lesions, rising from 20% forpatients with atypical squamous cells of undetermined significance to 48.1% for women with low-grade intraepithelial lesions and 86.3% for those with high-grade squamous intraepithelial lesions. These results suggest that testing for HPV E6 and E7 transcripts