高危型HPV感染的危险因素及血清miR-424和miR-222表达对宫颈癌的诊断价值

Risk factors for high-risk human papillomavirus infection and diagnostic value of serum miR-424 and miR-222 for cervical cancer

    摘要
  • 摘要:
    目的 分析宫颈癌患者血清miR-424和miR-222表达与高危型人乳头状瘤病毒（HPV）感染的危险因素，及其对宫颈癌的诊断价值。
    方法 选取2019年3月－2023年12月于湖北省中医院就诊并经宫颈活检诊断为宫颈癌的患者110例（宫颈癌组），选取同期明确诊断为宫颈病变的患者59例（宫颈病变组）及同期筛查的宫颈健康女性110例（对照组）。取所有研究对象的宫颈细胞样本检测高危型HPV感染情况，取血清检测miR-424、miR-222的表达；采用logistic回归分析归纳影响高危型HPV阳性的因素；分析miR-424、miR-222、高危型HPV对宫颈癌的诊断价值。
    结果 宫颈病变组、宫颈癌组患者的血清miR-424表达低于对照组，miR-222表达、高危型HPV阳性占比高于对照组（P＜0.05）；宫颈癌组血清miR-424表达低于宫颈病变组，miR-222表达、高危型HPV阳性占比高于宫颈病变组（P＜0.05）。高危型HPV阳性患者初次性生活年龄≤20岁比例（33.33%）、Ⅲ～Ⅳ期临床分期比例（57.69%）、miR-222表达（2.89±0.64）高于高危型HPV阴性患者，miR-424表达（0.43±0.05）低于高危型HPV阴性患者（P＜0.05）。初次性生活年龄≤20岁（OR=1.755）、低表达miR-424（OR=2.139）、高表达miR-222（OR=1.755）是高危型HPV阳性的危险因素（P＜0.05）。miR-424、miR-222、高危型HPV联合诊断宫颈癌的曲线下面积（AUC）为0.908，优于miR-424、miR-222、高危型HPV单独诊断（P＜0.001）。
    结论 宫颈癌高危型HPV感染阳性患者血清miR-424表达较低，miR-222表达较高，miR-424与高危型HPV阳性负相关，miR-222与高危型HPV阳性正相关，联合miR-424、miR-222、高危型HPV诊断宫颈癌具有良好的应用价值。

     

    Abstract:
    OBJECTIVE  To analyze the risk factors for high-risk human papillomavirus （HPV） infection and the diagnostic values of serum miR-424 and miR-222 for cervical cancer.
    METHODS  A total of 110 patients diagnosed with cervical cancer via cervical biopsy （cervical cancer group）, 59 patients diagnosed with cervical lesions （cervical lesion group） and 110 healthy women who underwent cervical screening （control group） during the same period were selected from Hubei Provincial Hospital of TCM between Mar. 2019 and Dec. 2023. Cervical cell samples from all subjects were tested for high-risk HPV infection, and serum levels of miR-424 and miR-222 were measured. Logistic regression analysis was employed to identify factors influencing high-risk HPV positivity. The diagnostic value of miR-424, miR-222 and high-risk HPV for cervical cancer was evaluated.
    RESULTS  Serum miR-424 level was lower, while miR-222 level and the proportion of high-risk HPV positivity were higher in the cervical lesion group and cervical cancer group than in the control group （P＜0.05）. Serum miR-424 level was lower, while miR-222 level and the proportion of high-risk HPV positivity were higher in the cervical cancer group than in the cervical lesion group （P＜0.05）. High-risk HPV-positive patients had a high proportion of first sexual intercourse before 20 years old （33.33%）, high proportion of advanced clinical stage （Ⅲ–Ⅳ） （57.69%） and miR-222 level （2.89±0.64）, but low miR-424 expression （0.43±0.05） compared to high-risk HPV-negative patients （P＜0.05）. First sexual intercourse before 20 years old （OR=1.755）, low miR-424 expression （OR=2.139） and high miR-222 level （OR=1.755） were identified as risk factors for high-risk HPV positivity （P＜0.05）. The combined diagnostic model of miR-424, miR-222 and high-risk HPV exhibited an area under the curve （AUC） of 0.908, outperforming individual markers （P＜0.001）.
    CONCLUSIONS  In patients with high-risk HPV-positive cervical cancer, serum miR-424 level is relatively low while miR-222 expression is relatively high. Serum miR-424 shows a negative correlation with high-risk HPV positivity, whereas miR-222 exhibits a positive correlation. The combined diagnostic value of miR-424, miR-222 and high-risk HPV demonstrates promising clinical utility for cervical cancer detection.

     

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