Keratin17联合HPV E6/E7 mRNA对宫颈低度鳞状上皮内病变转归的预测价值  

Predictive Value of Keratin17 Combined with HPV E6/E7 mRNA in the Outcome of Cervix Low-grade Squamous Intraepithelial Lesions

作　　者：吴莹 李媛 王晓燕 WU Ying;LI Yuan;WANG Xiaoyan(Department of Gynaecology and Obstetrics,Haian Hospital of Traditional Chinese Medicine,Nantong,Jiangsu,226600,China)

机构地区：[1]海安市中医院妇产科,江苏省南通市226600

出　　处：《医学分子生物学杂志》2024年第5期470-474,共5页Journal of Medical Molecular Biology

基　　金：2023年年度南通市自然科学基金和社会民生科技计划(指导性)项目(No.MMSZ2023231)。

摘　　要：目的研究Keratin17(Krt17)联合人乳头瘤病毒(human papillomavirus,HPV)E6/E7 mRNA对宫颈低度鳞状上皮内病变(low-grade squamous intraepithelial lesions,LSIL)转归的预测价值。方法选择2020年1月~2021年9月期间诊断为LSIL并完成24个月随访的患者,根据第24个月复诊时病变组织学检查结果进行分组,LSIL消退或维持的患者为病变未进展组,LSIL进展至更高级别的患者为病变进展组。比较2组患者首次确诊时临床资料、Krt17 mRNA表达水平、E6/E7拷贝数的差异,采用多因素logistic逐步回归分析LSIL病变进展的危险因素,采用ROC曲线分析Krt17联合E6/E7对LSIL病变进展的预测价值。结果98例LSIL患者中病变进展者19例、占19.39%,病变未进展者79例、占80.61%;病变进展组的LSIL患者年龄、吸烟比例、绝经比例、Krt17 mRNA表达水平、E6/E7拷贝数高于病变未进展组(P<0.05);多因素logistic逐步回归分析显示,年龄≥45岁、吸烟、Krt17 mRNA表达水平增加、E6/E7拷贝数增加是LSIL病变进展的危险因素;ROC曲线分析显示Krt17和E6/E7对LSIL病变进展具有预测价值,两指标联合预测的灵敏度和特异度分别为81.01%和94.74%。结论Krt17联合HPV E6/E7对LSIL病变进展具有一定预测价值。Objective To study the predictive value of Keratin17(Krt17)combined with human papillomavirus(HPV)E6/E7 mRNA in the prognosis of cervical low-grade squamous intraepithelial lesions(LSIL).Methods Patients diagnosed with LSIL from January 2020 to September 2021 and completed 24 months of follow-up were selected and grouped according to the histological findings of the lesions at the 24th month of return visit.Patients with LSIL regression or maintenance were classified as the non-lesion progression group,and patients with LSIL progression to a higher grade were classified as the lesion progression group.The clinical data,Krt17 mRNA expression level and E6/E7 copy number of the two groups were compared at the time of first diagnosis.The risk factors of LSIL lesion progression were analyzed by multivariate logistic step-by-step regression,and the predictive value of Krt17 combined with E6/E7 on LSIL lesion progression was analyzed by ROC curve.Results Among the 98 LSIL patients,19 cases(19.39%)progressed and 79 cases(80.61%)did not progress.The age,smoking rate,menopause rate,Krt17 mRNA expression level and E6/E7 copy number of LSIL patients in the lesion progression group were higher than those in the non-lesion progression group(P<0.05).Multivariate logistic regression analysis showed that age≥45 years,smoking,increased Krt17 mRNA expression level and E6/E7 copy number were risk factors for the progression of LSIL lesions.ROC curve analysis showed that Krt17 and E6/E7 had predictive value for the progression of LSIL lesions,and the sensitivity and specificity of the combined prediction of the two indexes were respectively 81.01%and 94.74%.Conclusion Krt17 combined with HPV E6/E7 can predict the progression of LSIL lesions.

关 键 词：宫颈低度鳞状上皮内病变 病变进展 Keratin17 人乳头瘤病毒E6/E7 

分 类 号：R711.74[医药卫生—妇产科学]