HPV E6/E7 mRNA的表达及阴道微生态与宫颈病变的关系

王艳; 王玲玲; 王才智

doi:10.16766/j.cnki.issn.1674-4152.002715

HPV E6/E7 mRNA的表达及阴道微生态与宫颈病变的关系

doi: 10.16766/j.cnki.issn.1674-4152.002715

蚌埠医学院第一附属医院妇产科，安徽蚌埠 233004

基金项目:

安徽省教育厅重点课题 KJ2021A0754

蚌埠医学院校重点课题 BYKY2019120ZD

详细信息

通讯作者:
王才智, E-mail: wangcaizhi211@163.com

中图分类号: R737.33 R730.231
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- 被引次数: 0
出版历程
- 收稿日期: 2022-04-06
- 网络出版日期: 2022-12-30

The Relationship between HPV E6/E7 mRNA, vaginal environment and cervical diseases

Department of Obstetrics and Gynecology, the First Affiliated Hospital of Bengbu Medical College, Bengbu, Anhui 233004, China

摘要

摘要: 目的探讨育龄期女性HPV E6/E7 mRNA的表达及阴道微生态异常与宫颈病变的关系。方法选取2019年12月—2021年8月在蚌埠医学院第一附属医院妇产科门诊及住院部因行宫颈癌筛查就诊的患者，共纳入1 245例育龄患者。所有患者均行阴道镜检查，根据阴道镜病理检查结果分为子宫颈上皮内瘤变(CIN)Ⅰ组290例，CINⅡ组360例，CINⅢ组465例，子宫颈鳞状细胞癌(CECS)组130例，另纳入150例健康女性为对照组。通过检测宫颈HPV E6/E7 mRNA的表达和阴道分泌物病原体，分析其与宫颈疾病的关系。结果各组阴道清洁度比较差异有统计学意义(χ²=46.123，P < 0.05)，其中阴道清洁度Ⅲ~Ⅳ检出率对照组 < CINⅠ组 < CINⅡ组 < CINⅢ组 < CECS组；各组加德纳菌阳性检出率差异有统计学意义(χ²=39.404，P < 0.05)；各组念珠菌阳性及滴虫阳性检出率差异均无统计学意义(均P＞0.05)；各组HPV E6/E7 mRNA阳性检出率比较差异有统计学意义(χ²=287.386，P < 0.05)，CINⅠ组、CINⅡ组、CINⅢ组、CECS组、对照组HPV E6/E7 mRNA阳性检出率分别为50.7%、81.9%、76.1%、79.2%、13.3%；CINⅠ组、CINⅡ组、CINⅢ组、CESC组中HPV E6/E7 mRNA的阳性表达率与阴道微生态失调率相关(均P < 0.05)。Logistic回归分析显示阴道清洁度Ⅰ~Ⅱ度及乳酸杆菌阳性是HPV E6/E7 mRNA表达的独立保护因素(OR < 1，均P < 0.05)。结论 HPV E6/E7 mRNA的表达阳性率增加、阴道清洁度(Ⅲ~Ⅳ)检出率增加、加德纳菌阳性检出率增加均为预测宫颈癌或宫颈癌前病变的高危因素。
- 人乳头瘤病毒E6/E7 mRNA /
- 宫颈上皮内病变 /
- 宫颈癌 /
- 阴道微生态
Abstract: Objective To investigate the relationship between the expression of HPV E6/E7 mRNA, vaginal microecological abnormalities and cervical lesions in women of childbearing age. Methods A total of 1 245 patients of reproductive age who were admitted to the outpatient and inpatient Departments of Obstetrics and Gynecology of the First Affiliated Hospital of Bengbu Medical College for cervical cancer screening from December 2019 to August 2021 were enrolled. All patients were examined by colposcopy. According to the results of colposcopy pathology, there were 290 cases in cervical intraepithelial neoplasia (CIN) Ⅰ group, 360 cases in CIN Ⅱ group, 465 cases in CIN Ⅲ group, 130 cases in cervical squamous cell carcinoma group and 150 healthy women in control group. By detecting the expression of HPV E6/E7 mRNA and the pathogen of vaginal secretions, the relationship between HPV E6/E7 mRNA and cervical diseases was compared. Results There was a statistically significant difference in vaginal cleanliness among the groups (χ²=46.123, P < 0.05), among which the detection rate of vaginal cleanliness Ⅲ-Ⅳ in the control group < CIN Ⅰ group < CIN Ⅱ group < CIN Ⅲ group < CECS group. The positive detection rate of Gardnerella in each group was statistically significant (χ²=39.404, P < 0.05). There was no significant difference in the positive rates of candida and trichomonas in each group (P>0.05). The positive detection rate of HPV E6/E7 mRNA in each group was statistically significant (χ²=287.386, P < 0.05). The positive detection rates of HPV E6/E7 mRNA in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ, CECS and control groups were 50.7%, 81.9%, 76.1%, 79.2% and 13.3%, respectively. The positive expression rate of HPV E6/E7 mRNA in CIN Ⅰ, CIN Ⅱ, CIN Ⅲ and CESC groups was correlated with the rate of vaginal microecology disorder (P < 0.05). Logistic regression analysis showed that vaginal cleanliness (Ⅰ- Ⅱ) and lactobacillus were independent protective factors for HPV E6/E7 mRNA expression (OR < 1, all P < 0.05). Conclusion The increased positive rate of HPV E6/E7 mRNA expression, the increased detection rate of vaginal cleanliness (Ⅲ- Ⅳ), and the increased positive detection rate of Gardnerella are all high risk factors for predicting cervical cancer or cervical precancerous lesions.
- Human papilloma virus E6/E7 mRNA /
- Cervical intraepithelial neoplasia /
- Cervical cancer /
- Vaginal microecology

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表 1 各组研究对象阴道微生物检出率比较[例(%)]

Table 1. Vaginal microbial abnormalities in relation to cervical disease [cases (%)]

组别	例数	阴道清洁度		加德纳菌		念珠菌		滴虫		乳酸杆菌
组别	例数	Ⅰ~Ⅱ	Ⅲ~Ⅳ	+	-	+	-	+	-	+	-
CINⅠ组	290	238(82.1)	52(17.9)	45(15.5)	245(84.5)	17(5.9)	273(94.1)	14(4.8)	276(95.2)	122(42.1)	168(57.9)
CINⅡ组	360	276(76.7)	84(23.3)	78(21.7)	282(78.3)	25(6.9)	335(93.1)	32(8.9)	328(91.1)	119(33.1)	241(66.9)
CINⅢ组	465	332(71.4)	133(28.6)	103(22.2)	362(77.8)	33(7.1)	432(92.9)	38(8.2)	427(91.8)	155(33.3)	310(66.7)
CESC组	130	81(62.3)	49(37.7)	45(34.6)	85(65.4)	8(6.2)	122(93.8)	10(7.7)	120(92.3)	30(23.1)	100(76.9)
对照组	150	138(92.0)	12(8.0)	10(6.7)	140(93.3)	9(6.0)	141(94.0)	8(5.3)	142(94.7)	63(42.0)	87(58.0)
χ²值		46.123		39.404		0.642		5.364		17.837
P值		< 0.001		< 0.001		0.958		0.252		< 0.001
注：“+”为阳性；“-”为阴性。

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表 2 各组研究对象HPV E6/E7 mRNA表达情况比较[例(%)]

Table 2. Relationship between HPVE6/E7 mRNA expression and cervical disease [cases (%)]

组别	例数	HPV E6/E7 mRNA
组别	例数	+	-
CINⅠ组	290	147(50.7)	143(49.3)
CINⅡ组	360	295(81.9)	65(19.1)
CINⅢ组	465	354(76.1)	111(33.9)
CECS组	130	103(79.2)	27(21.8)
对照组	150	20(13.3)	130(86.7)
χ²值		287.386
P值		< 0.001

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表 3 各组研究对象HPV E6/E7 mRNA表达与阴道微生态异常的关系[例(%)]

Table 3. Relationship between HPV E6/E7 mRNA expression and vaginal microecological abnormalities in each group[cases (%)]

组别	阴道微生态正常	阴道微生态失调	χ²值	P值
CINⅠ组			19.063	< 0.001
HPV E6/E7 mRNA(+)	77(26.5)	70(24.1)
HPV E6/E7 mRNA(-)	110(37.9)	33(11.4)
CINⅡ组			18.439	< 0.001
HPV E6/E7 mRNA(+)	165(45.8)	130(36.1)
HPV E6/E7 mRNA(-)	55(15.3)	10(2.8)
CINⅢ组			20.520	< 0.001
HPV E6/E7 mRNA(+)	192(41.3)	162(34.8)
HPV E6/E7 mRNA(-)	87(18.7)	24(5.2)
CESC组			4.135	0.042
HPV E6/E7 mRNA(+)	58(44.6)	45(34.6)
HPV E6/E7 mRNA(-)	21(16.2)	6(4.6)
对照组			3.631	0.057
HPV E6/E7 mRNA(+)	14(9.3)	6(4.0)
HPV E6/E7 mRNA(-)	116(77.3)	14(9.3)

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表 4 HPV E6/E7 mRNA表达影响因素的logistic回归分析

Table 4. Logistic regression analysis of the expression of HPVE6/E7 mRNA

变量	B	SE	Wald χ²	P值	OR值	95% CI
阴道清洁度(Ⅲ~Ⅳ)	1.307	0.187	48.995	< 0.001	3.695	2.256~5.327
滴虫	-0.396	0.258	2.351	0.125	0.673	0.405~1.117
加德纳菌	0.586	0.186	9.959	0.002	1.797	1.249~2.586
念珠菌	-0.269	0.280	0.924	0.336	0.764	0.441~1.323
乳酸杆菌	-2.504	0.142	309.183	< 0.001	0.082	0.062~0.108

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