T淋巴细胞亚群联合ALOX12B对高危型HPV感染病情自然转归的预测价值  

The predictive value of T lymphocyte subsets combined with ALOX12B on the nature progression of high-risk HPV infection

作　　者：刘敏[1] 杨易[2] 刘兰 夏春兰 LIU Min;YANG Yi;LIU Lan;XIA Chunlan(Department of Gynecology,Zigong Maternal and Child Health Hospital,Zigong,Sichuan 643000,China;Department of Women′s Health,Zigong Maternal and Child Health Hospital,Zigong,Sichuan 643000,China)

机构地区：[1]四川省自贡市妇幼保健院妇科,四川自贡643000 [2]四川省自贡市妇幼保健院妇女保健科,四川自贡643000

出　　处：《检验医学与临床》2025年第4期485-490,495,共7页Laboratory Medicine and Clinic

基　　金：四川省医学(青年创新)科研课题(S20601)。

摘　　要：目的探讨T淋巴细胞亚群联合12(R)-脂加氧酶(ALOX12B)预测高危型人乳头瘤病毒(HPV)感染病情自然转归的价值。方法选择2020年1月至2021年2月该院收治的179例高危型HPV感染者作为研究对象,根据2年随访期内病情自然转归情况分为转阴组、持续阳性组。比较2组临床资料、CD3^(+)、CD4^(+)T淋巴细胞比例,以及CD4^(+)T淋巴细胞/CD8^(+)T淋巴细胞比值(简称CD4^(+)/CD8^(+))、ALOX12B mRNA。采用Logistic回归分析高危型HPV感染病情自然转归的影响因素。采用受试者工作特征(ROC)曲线分析T淋巴细胞亚群、ALOX12B mRNA预测高危型HPV感染病情自然转归价值。结果179例高危型HPV感染者,随访2年,失访1例,获访患者中,124例(69.66%)自然转阴,54例(30.34%)持续阳性(持续阳性组),持续阳性患者中5例(9.26%)病情发生进展。持续阳性组活检结果为宫颈上皮内瘤样病变(CIN)Ⅰ级、细胞学≥未明确意义的非鳞状上皮细胞患者占比及高危型HPV负荷量高于转阴组(P<0.05)。持续阳性组CD3^(+)、CD4^(+)T淋巴细胞比例,以及CD4^(+)/CD8^(+)低于转阴组(P<0.05),ALOX12B mRNA表达水平高于转阴组(P<0.05)。Logistic回归分析结果显示,校正了活检结果后,CD3^(+)、CD4^(+)T淋巴细胞比例,以及CD4^(+)/CD8^(+)、ALOX12B mRNA是高危型HPV感染病情自然转归的影响因素(P<0.05)。ROC曲线分析结果显示,CD3^(+)T淋巴细胞比例、CD4^(+)/CD8^(+)、ALOX12B mRNA联合预测高危型HPV感染病情自然转归的曲线下面积为0.928(95%CI:0.879~0.961)。结论CD3^(+)、CD4^(+)T淋巴细胞比例,CD4^(+)/CD8^(+),ALOX12B mRNA是高危型HPV感染病情自然转归的影响因素,T淋巴细胞亚群联合ALOX12B检测可作为预测病情自然转归的方案,为临床决策提供参考信息。Objective To investigate the predictive value of T lymphocyte subsets combined with 12(R)-lipoxygenase(ALOX12B)in the nature progression of high-risk human papillomavirus(HPV)infection.Methods A total of 179 patients with high-risk HPV infection admitted to the hospital from January 2020 to February 2021 were selected as research subjects.Based on the natural progression of their condition during a 2-year follow-up period,they were divided into the clearance group and the persistent positive group.Clinical data,proportions of CD3^(+)and CD4^(+)T lymphocytes,the CD4^(+)/CD8^(+)T lymphocyte ratio(CD4^(+)/CD8^(+))and ALOX12B mRNA levels were compared between the two groups.Logistic regression analysis was used to identify factors influencing the natural progression of high-risk HPV infection.Receiver operating characteristic(ROC)curve was applied to evaluate the predictive value of T lymphocyte subsets and ALOX12B mRNA for the natural progression of high-risk HPV infection.Results During the 2-year follow-up,1 case was lost to follow-up among the 179 patients with high-risk HPV infection.Among the patients who were followed up,124 cases(69.66%)showed natural clearance,while 54 cases(30.34%)remained persistently positive(persistent positive group).Among the persistently positive patients,5 cases(9.26%)experienced disease progression.The proportion of patients with biopsy results of cervical intraepithelial neoplasia(CIN)gradeⅠ,and those with cytology≥atypical squamous cells of undetermined significance,as well as the high-risk HPV viral load in the persistent positive group were higher than those in the clearance group(P<0.05).The proportions of CD3^(+)and CD4^(+)T lymphocytes,as well as the CD4^(+)/CD8^(+)in the persistent positive group were lower than those in the clearance group(P<0.05),while the ALOX12B mRNA level was higher than that in the persistent positive group(P<0.05).Logistic regression analysis showed that,after adjusting for biopsy results,the proportions of CD3^(+)and CD4^(+)T lymphocytes,the CD4^

关 键 词：T淋巴细胞亚群 12(R)-脂加氧酶 高危型人乳头瘤病毒 持续感染 病情转归 

分 类 号：R711.32[医药卫生—妇产科学] R446.5[医药卫生—临床医学]