高危型HPV感染对宫颈阴道微生态菌群及miR-222、miR-18a表达的影响  

Effect of high risk human papillomavirus infection on cervical and vaginal microflora and the expression of miR-222 and miR-18a

作　　者：李阳芳 程群仙 徐灵 李航[1] 杨杰[1] 倪秀文 卢雨晴 LI Yang-fang;CHENG Qun-xian;XU Ling(Department of Obstetrics and Gynecology,Minhang Hospital Affiliated to Fudan University(Shanghai Minhang District Central Hospital),Shanghai 201199,China)

机构地区：[1]复旦大学附属闵行医院(上海市闵行区中心医院)妇产科,上海201199

出　　处：《临床和实验医学杂志》2023年第4期389-393,共5页Journal of Clinical and Experimental Medicine

基　　金：上海市卫计委临床医学科研支持项目(编号:201840340);复旦大学附属闵行医院院级课题支持项目(编号:2020MHLC05)。

摘　　要：目的分析高危型人乳头瘤病毒(HR-HPV)感染对宫颈阴道微生态菌群及miR-222、miR-18a表达的影响。方法前瞻性选取2020年1月至2021年5月复旦大学附属闵行医院妇产科门诊随机行宫颈筛查的妇女共1500例,均行HPV检测,根据是否感染,分为HR-HPV阴性组(n=1338)和HR-HPV阳性组(n=162)。采用PCR法检测宫颈和阴道脱落细胞中HR-HPV的感染情况;DNA探针技术检测阴道分泌物中加德纳细菌(BV)、霉菌(VVC)和滴虫(TV)感染情况;阴道微生态检测仪Unit-500检测过氧化氢(H_(2)O_(2))、唾液酸苷酶和白细胞酯酶;实时定量荧光PCR检测miR-222和miR-18a的表达;Spearman法分析阴道微生态和miR-222、miR-18a的相关性。采用单因素和多因素Logistic回归模型分析HR-HPV感染的影响因素。结果1500例筛查人群中,检出的HR-HPV感染者162例,HPV16检出率最高,为91例,占比56.17%。HR-HPV阳性组受试者菌群多样性Ⅱ~Ⅲ级比率、BV阳性率、H_(2)O_(2)阳性率为33.95%、30.86%、95.06%,均显著高于HR-HPV阴性组(25.64%、20.25%、89.91%),差异均有统计学意义(P<0.05),两组VVC、TV、唾液酸苷酶和白细胞酯酶比较,差异无统计学意义(P>0.05)。HR-HPV阳性组中miR-222和miR-18a的表达量为2.73±0.46、3.11±0.52,明显高于HR-HPV阴性组(0.56±0.08、0.82±0.13),差异有统计学意义(P<0.05)。BV阳性率和miR-222、miR-18a呈正相关(r=0.397、0.256,P<0.05),H_(2)O_(2)阳性率与miR-222、miR-18a也呈正相关(r=0.321、0.373,P<0.05)。单多因素回归分析结果显示,BV阳性率、H_(2)O_(2)阳性率、miR-222、miR-18a是影响HR-HPV感染危险因素(OR=1.963,95%CI=1.032~3.735;OR=1.671,95%CI=0.584~4.779;OR=1.296,95%CI=0.802~2.094;OR=1.374,95%CI=1.003~2.753,P<0.05)。结论HR-HPV感染患者的微生态环境紊乱,miR-222、miR-18a的表达明显升高,且BV阳性率、H_(2)O_(2)阳性率、miR-222、miR-18a是影响HR-HPV感染危险因素。治疗中了解HR-HPV感染的危险因素,有利于针对HR-HPV感染患者制定个体�Objective To analyze the effect of high risk human papillomavirus(HR-HPV)infection on cervical and vaginal microflora and the expression of miR-222 and miR-18a.Methods A total of 1500 women who underwent cervical screening at random in the gynecological clinic of Minhang Hospital Affiliated to Fudan University from January 2020 to may 2021 were prospectively selected.All of them underwent HPV testing.According to whether they were infected,they were divided into HR-HPV negative group(n=1338)and HR-HPV positive group(n=162).HR-HPV infection in cervical and vaginal exfoliated cells was detected by PCR;Gardner’s bacterial(BV),fungal(VVC)and trichomonad(TV)infections in vaginal secretions were detected by DNA probe technique;Hydrogen peroxide(H_(2)O_(2)),sialidosidase and leukocyte esterase were detected with the vaginal microecology detector unit-500.The expression of miR-222 and miR-18a was detected by real-time quantitative fluorescent PCR;Spearman method was used to analyze the correlation between vaginal microenvironment and miR-222,miR-18a,and univariate and multivariate Logistic regression models were used to analyze the influencing factors of HR-HPV infection.Results Among the 1500 screening population,162 cases of HR-HPV infection were detected,and the detection rate of HPV16 was the highest,91 cases,accounting for 56.17%.The rate of grade Ⅱ-Ⅲ bacterial diversity,BV positive rate,and H_(2)O_(2)positive rate in HR-HPV positive group were 33.95%,30.86%,95.06%,which were significantly higher than those in HR-HPV negative group(25.64%,20.25%,89.91%),and the differences were statistically significant(P<0.05),while VVC,TV,sialidase and leukocyte esterase of the two groups were compared,and the difference was not statistically significant(P>0.05).The expression of miR-222 and miR-18a in HR-HPV positive group was 2.73±0.46,3.11±0.52,which was significantly higher than that in HR-HPV negative group(0.56±0.08,0.82±0.13),and the difference was statistically significant(P<0.05).BV positive rate was positively

关 键 词：高危型人乳头瘤病毒 宫颈阴道微生态 MIR-222 miR-18a 

分 类 号：R711[医药卫生—妇产科学]