HPV E6/E7 mRNA的表达及阴道微生态与宫颈病变的关系  

The Relationship between HPV E6/E7 mRNA,vaginal environment and cervical diseases

作　　者：王艳[1] 王玲玲[1] 王才智[1] WANG Yan;WANG Ling-ling;WANG Cai-zhi(Department of Obstetrics and Gynecology,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui 233004,China)

机构地区：[1]蚌埠医学院第一附属医院妇产科,安徽蚌埠233004

出　　处：《中华全科医学》2022年第11期1841-1844,共4页Chinese Journal of General Practice

基　　金：安徽省教育厅重点课题(KJ2021A0754);蚌埠医学院校重点课题(BYKY2019120ZD)。

摘　　要：目的探讨育龄期女性HPV E6/E7 mRNA的表达及阴道微生态异常与宫颈病变的关系。方法选取2019年12月—2021年8月在蚌埠医学院第一附属医院妇产科门诊及住院部因行宫颈癌筛查就诊的患者,共纳入1245例育龄患者。所有患者均行阴道镜检查,根据阴道镜病理检查结果分为子宫颈上皮内瘤变(CIN)Ⅰ组290例,CINⅡ组360例,CINⅢ组465例,子宫颈鳞状细胞癌(CECS)组130例,另纳入150例健康女性为对照组。通过检测宫颈HPV E6/E7 mRNA的表达和阴道分泌物病原体,分析其与宫颈疾病的关系。结果各组阴道清洁度比较差异有统计学意义(χ^(2)=46.123,P<0.05),其中阴道清洁度Ⅲ~Ⅳ检出率对照组<CINⅠ组<CINⅡ组<CINⅢ组<CECS组;各组加德纳菌阳性检出率差异有统计学意义(χ^(2)=39.404,P<0.05);各组念珠菌阳性及滴虫阳性检出率差异均无统计学意义(均P>0.05);各组HPV E6/E7 mRNA阳性检出率比较差异有统计学意义(χ^(2)=287.386,P<0.05),CINⅠ组、CINⅡ组、CINⅢ组、CECS组、对照组HPV E6/E7 mRNA阳性检出率分别为50.7%、81.9%、76.1%、79.2%、13.3%;CINⅠ组、CINⅡ组、CINⅢ组、CESC组中HPV E6/E7 mRNA的阳性表达率与阴道微生态失调率相关(均P<0.05)。Logistic回归分析显示阴道清洁度Ⅰ~Ⅱ度及乳酸杆菌阳性是HPV E6/E7 mRNA表达的独立保护因素(OR<1,均P<0.05)。结论HPV E6/E7 mRNA的表达阳性率增加、阴道清洁度(Ⅲ~Ⅳ)检出率增加、加德纳菌阳性检出率增加均为预测宫颈癌或宫颈癌前病变的高危因素。Objective To investigate the relationship between the expression of HPV E6/E7 mRNA,vaginal microecological abnormalities and cervical lesions in women of childbearing age.Methods A total of 1245 patients of reproductive age who were admitted to the outpatient and inpatient Departments of Obstetrics and Gynecology of the First Affiliated Hospital of Bengbu Medical College for cervical cancer screening from December 2019 to August 2021 were enrolled.All patients were examined by colposcopy.According to the results of colposcopy pathology,there were 290 cases in cervical intraepithelial neoplasia(CIN)Ⅰ group,360 cases in CINⅡ group,465 cases in CINⅢ group,130 cases in cervical squamous cell carcinoma group and 150 healthy women in control group.By detecting the expression of HPV E6/E7 mRNA and the pathogen of vaginal secretions,the relationship between HPV E6/E7 mRNA and cervical diseases was compared.Results There was a statistically significant difference in vaginal cleanliness among the groups(χ^(2)=46.123,P<0.05),among which the detection rate of vaginal cleanliness Ⅲ-Ⅳ in the control group<CINⅠ group<CINⅡ group<CINⅢ group<CECS group.The positive detection rate of Gardnerella in each group was statistically significant(χ^(2)=39.404,P<0.05).There was no significant difference in the positive rates of candida and trichomonas in each group(P>0.05).The positive detection rate of HPV E6/E7 mRNA in each group was statistically significant(χ^(2)=287.386,P<0.05).The positive detection rates of HPV E6/E7 mRNA in CINⅠ,CINⅡ,CINⅢ,CECS and control groups were 50.7%,81.9%,76.1%,79.2% and 13.3%,respectively.The positive expression rate of HPV E6/E7 mRNA in CINⅠ,CINⅡ,CINⅢ and CESC groups was correlated with the rate of vaginal microecology disorder(P<0.05).Logistic regression analysis showed that vaginal cleanliness(Ⅰ-Ⅱ)and lactobacillus were independent protective factors for HPV E6/E7 mRNA expression(OR<1,all P<0.05).Conclusion The increased positive rate of HPV E6/E7 mRNA expression,the inc

关 键 词：人乳头瘤病毒E6/E7 mRNA 宫颈上皮内病变 宫颈癌 阴道微生态 

分 类 号：R737.33[医药卫生—肿瘤] R730.231[医药卫生—临床医学]