血清Th1/Th2细胞因子联合肿瘤标志物诊断HR-HPV阳性宫颈癌的价值分析  

Analysis on value of serum Th1/Th2 cytokines combined with tumor markers in diagnosis of high-risk HPV positive cervical cancer

作　　者：陈秀英[1] 陈娜[1] 李晓丹 崔建涛 张士表[1] CHEN Xiuying;CHEN Na;LI Xiaodan;CUI Jiantao;ZHANG Shibiao(Department of Gynecology,Cangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Cangzhou,Hebei 061000,China)

机构地区：[1]河北省沧州中西医结合医院妇科,河北沧州061000

出　　处：《检验医学与临床》2025年第9期1226-1230,1235,共6页Laboratory Medicine and Clinic

基　　金：河北省中医药管理局中医药类科研计划课题(2020486)。

摘　　要：目的分析血清辅助性T细胞1(Th1)/辅助性T细胞2(Th2)细胞因子联合肿瘤标志物诊断高危型人乳头瘤病毒(HR-HPV)阳性宫颈癌的价值。方法选取2019年1月至2023年6月该院收治的49例HR-HPV阳性宫颈癌患者作为研究组,选取同期该院收治的同年龄段49例HR-HPV阳性宫颈良性疾病患者作为对照组。比较2组基础资料、血清Th1/Th2细胞因子[白细胞介素(IL)-10、IL-6、干扰素-γ(IFN-γ)、肿瘤坏死因子-α(TNF-α)]、肿瘤标志物[鳞状细胞癌抗原(SCC-Ag)、糖类抗原199(CA199)、细胞角蛋白19片段抗原21-1(CYFRA21-1)]水平;比较研究组不同临床病理特征患者血清Th1/Th2细胞因子水平;采用Pearson相关分析HR-HPV阳性宫颈癌患者血清Th1/Th2细胞因子水平与肿瘤标志物水平的相关性;绘制受试者工作特征(ROC)曲线分析血清Th1/Th2细胞因子及肿瘤标志物诊断HR-HPV阳性宫颈癌的价值。结果研究组血清IL-10、IL-6、IFN-γ、TNF-α、SCC-Ag、CA199、CYFRA21-1水平均高于对照组(P<0.05)。研究组国际妇产科联盟分期(FIGO)Ⅲ~Ⅳ期患者血清IL-10、IL-6、IFN-γ、TNF-α水平均高于Ⅰ~Ⅱ期患者(P<0.05),肌层浸润深度≥1/2的患者血清IL-10、IL-6、IFN-γ、TNF-α水平均高于肌层浸润深度<1/2患者(P<0.05)。HR-HPV阳性宫颈癌患者血清IL-10、IL-6、IFN-γ、TNF-α水平与SCC-Ag、CA199、CYFRA21-1水平均呈正相关(P<0.05)。IL-10、IL-6、IFN-γ、TNF-α单项诊断HR-HPV阳性宫颈癌的AUC分别为0.809、0.773、0.801、0.794,SCC-Ag、CA199、CYFRA21-1单项诊断HR-HPV阳性宫颈癌的AUC分别为0.831、0.728、0.789,血清IL-10、IL-6、IFN-γ、TNF-α、SCC-Ag、CA199、CYFRA21-1联合诊断HR-HPV阳性宫颈癌的AUC为0.927,联合诊断的AUC大于各指标单独诊断的AUC(Z=2.116、2.690、2.341、2.565、1.957、3.351、2.631,P=0.034、0.007、0.019、0.010、0.039、0.001、0.009)。结论血清IL-10、IL-6、IFN-γ、TNF-α可作为HR-HPV阳性宫颈癌的辅助诊断指标,与SCC-Ag、CA199�Objective To analyze the value of serum helper T cell 1(Th1)/helper T cell 2(Th2)cytokines combined with tumor markers in diagnosing high-risk human papillomavirus(HR-HPV)positive cervical cancer.Methods A total of 49 cases of HR-HPV positive cervical cancer in this hospital from January 2019 to June 2023 were selected as the study group,and 49 cases of HR-HPV positive cervical benign diseases in the same age group during the same period were selected as the control group.The basic data,serum Th1/Th2 cytokines[interleukin-10(IL-10),interleukin-6(IL-6),interferon-γ(IFN-γ),tumor necrosis factor-α(TNF-α)],tumor markers[squamous cell carcinoma antigen(SCC-Ag),carbohydrate antigen 199(CA199),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)]levels were compared between the two groups.The serum Th1/Th2 cytokines were compared among the patients with different pathological characteristics in the study group.The correlation between serum Th1/Th2 cytokines and tumor markers levels in HR-HPV positive cervical cancer patients was analyzed by Pearson correlation.The receiver operating characteristic(ROC)curve was drawn to analyze the value of serum Th1/Th2 cytokines and tumor markers for diagnosing HR-HPV positive cervical cancer.Results The serum IL-10,IL-6,IFN-γ,TNF-α,SCC-Ag,CA199 and CYFRA21-1 levels in the study group were higher than those in the control group(P<0.05).The levels of serum IL-10,IL-6,IFN-γand TNF-αin the patients with FIGO stageⅢ-Ⅳwere higher than those in the patients with stageⅠ-Ⅱ,and the levels of serum IL-10,IL-6,IFN-γand TNF-αin the patients with myometrial invasion depth≥1/2 were higher than those in the patients with myometrial invasion depth<1/2(P<0.05).The serum IL-10,IL-6,IFN-γand TNF-αlevels in the patients with HR-HPV positive cervical cancer were positively correlated with the SCC-Ag,CA199 and CYFRA21-1 levels(P<0.05);the area under the curve(AUC)of serum IL-10,IL-6,IFN-γ,and TNF-αfor single item diagnosing HR-HPV positive cervical cancer was 0.809,0.773,0.801 and 0.794,

关 键 词：宫颈癌 高危型人乳头瘤病毒 细胞因子 肿瘤标志物 诊断 

分 类 号：R446.11[医药卫生—诊断学] R737.33[医药卫生—临床医学]