高危型HPV阳性患者血清中HDAC6和Hsp90联合检测在宫颈癌前病变诊断中的临床意义  

Clinical significance of combined detection of serum histone deacetylase 6 and heat shock protein 90 of high-risk human papilloma virus-positive patients in the diagnosis of cervical precancerous lesions

作　　者：郝栋栋 王晓娟 高凤春 李武珊 石倩 HAO Dongdong;WANG Xiaojuan;GAO Fengchun;LI Wushan;SHI Qian(Jinan Maternal and Child Health Care Hospital Affiliated to Shandong First Medical University(Jinan Maternal and Child Health Care Hospital),Jinan 250001,Shandong,China)

机构地区：[1]山东第一医科大学附属济南妇幼保健院(济南市妇幼保健院),济南250001

出　　处：《中国性科学》2024年第3期82-87,共6页Chinese Journal of Human Sexuality

基　　金：济南市卫生健康委员会资助项目(2020-4-75)。

摘　　要：目的探究高危型人乳头瘤病毒(HR-HPV)阳性患者血清中组蛋白脱乙酰酶6(HDAC6)和热休克蛋白90(Hsp90)联合检测在宫颈癌前病变诊断中的临床意义。方法纳入2020年6月至2021年6月在山东第一医科大学附属济南妇幼保健院接受治疗的166例HR-HPV阳性患者作为研究对象,根据阴道镜检查和活检结果将研究对象分为实验组[高级别鳞状上皮内病变(HSIL)56例、低级别鳞状上皮内病变(LSIL)30例]、对照组(子宫颈良性病变患者80例)。采用酶联免疫吸附试验(ELISA)法检测患者血清HDAC6、Hsp90水平;采用Logistic多因素回归分析HR-HPV患者发生宫颈癌前病变的影响因素;采用受试者工作特征(ROC)曲线评价血清HDAC6、Hsp90对HR-HPV患者发生宫颈癌前病变的诊断价值。结果相较于对照组,实验组吸烟、有盆腔炎病史及性传播疾病感染史患者占比和白细胞、中性粒细胞、白介素-6(IL-6)、白介素-1β(IL-1β)、肿瘤坏死因子-α(TNF-α)、C反应蛋白(CRP)、HDAC6、Hsp90水平显著升高(P<0.05)。Logistic多因素回归分析显示,性传播疾病感染史及IL-6、IL-1β、TNF-α、CRP、HDAC6、Hsp90水平均是HR-HPV阳性患者发生宫颈癌前病变的独立危险因素(P<0.05)。ROC曲线结果显示,血清HDAC6、Hsp90水平及二者联合预测HR-HPV阳性患者发生宫颈癌前病变的曲线下面积(AUC)分别为0.759、0.774、0.870,其中联合预测的AUC显著高于二者单独预测的AUC(Z=2.361、2.042,P<0.05)。HSIL患者IL-6、IL-1β、TNF-α、CRP、HDAC6、Hsp90水平显著高于LSIL患者(P<0.05)。结论血清HDAC6、Hsp90在HR-HPV阳性发生宫颈癌前病变患者中水平升高,均是HR-HPV阳性患者发生宫颈癌前病变的独立危险因素,有望成为HR-HPV阳性患者发生宫颈癌前病变的诊断因子。Objective To explore the clinical significance of the combined detection of serum histone deacetylase 6(HDAC6)and heat shock protein 90(Hsp90)of high-risk human papilloma virus-positive(HR-HPV)patients in the diagnosis of cervical precancerous lesions.Methods A total of 166 high-risk HPV positive patients who received treatment at Jinan Maternity and Child Health Care Hospital Affiliated to Shandong First Medical University from June 2020 to June 2021 were selected as study objects,and they were further divided into experimental group[56 cases of high grade squamous intraepithelial lesion(HSIL),30 cases of low grade squamous intraepithelial lesion(LSIL)],and control group(80 cases with benign cervical lesions)based on colposcopy and biopsy results.The serum levels of HDAC6 and Hsp90 were detected by enzyme-linked immunosorbent assay(ELISA).Multivariate Logistic regressionanalysis was applied to analyze the influencing factors of cervical precancerous lesions in HR-HPV-positive patients.Receiver operating characteristic(ROC)curve was applied to evaluate the diagnostic value of serum HDAC6 and Hsp90 in HR-HPV-positive patients with cervical precancerous lesions.Results Compared with the control group,the proportions of patients with smoking,a history of pelvic inflammatory disease,a history of sexually transmitted infection history,and the levels of leukocytes,neutrophils,interleukin-6(IL-6),interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),C-reactive protein(CRP),HDAC6,and Hsp90 in the experimental group were significantly higher(P<0.05).Multivariate Logistic regression analysis showed that the history of sexually transmitted infections,the levels of IL-6,IL-1β,TNF-α,CRP,HDAC6,and Hsp90 were all independent risk factors for cervical precancerous lesions in HR-HPV-positive patients(P<0.05).ROC results showed that the area under ROC curve(AUC)for cervical precancerous lesions in HR-HPV-positive patients predicted by serum levels of HDAC6 and Hsp90 and the combination of HDAC6 and Hsp90 was 0.759,0.774 and 0

关 键 词：高危型人乳头瘤病毒阳性 宫颈癌前病变 组蛋白脱乙酰酶6 热休克蛋白90 诊断价值 

分 类 号：R711[医药卫生—妇产科学]