摘要
目的:探究阴道微生态失衡联合血清人类白细胞抗原-G(HLA-G)、人类白细胞抗原-E(HLA-E)水平对宫颈高级别上皮内瘤变(HSIL)患者冷刀锥切(CKC)术后人乳头瘤病毒(HPV)持续感染的预测价值。方法:回顾性收集2021年1月-2022年12月本院收治HSIL患者137例临床资料,均行CKC治疗并术后随访1年,观察术后HPV持续感染情况,测定阴道微生态及血清HLA-G、HLA-E,分析阴道微生态及血清HLA-G、HLA-E水平与HPV持续感染关系以及评估价值。结果:137例术后1年内HPV持续感染31例(阳性组),HPV持续感染率为22.6%,未持续感染106例(阴性组),两组阴道pH值,阴道菌群密集度、多样性及滴虫阴道炎发生等均有差异,阳性组阴道微生态失衡率高于阴性组,血清HLA-G(19.84±3.53 ng/ml)、HLA-E(75.39±15.83 pg/ml)水平均高于阴性组(16.93±2.96 ng/ml、68.42±12.51 pg/ml),阳性组中阴道微生态失衡者血清HLA-G、HLA-E水平高于阴道微生态正常者(均P<0.05);Spearman相关分析显示,阴道微生态失衡、血清HLA-G、HLA-E水平与术后HPV持续感染呈正相关(r=0.633、0.529、0.608,均P<0.05);受试者工作特征曲线分析显示,阴道微生态失衡、血清HLA-G、HLA-E水平及联合评估术后HPV持续感染的曲线下面积分别为0.601、0.773、0.805、0.885(P<0.05)。结论:阴道微生态失衡联合血清HLA-G、HLA-E水平有对HSIL患者CKC术后HPV持续感染有一定预测价值。
Objective:To explore the predictive value of the vaginal microecological imbalance combined with the serum human leukocyte antigen-G(HLA-G) and human leukocyte antigen(HLA-E) levels of patients with cervical highgrade squamous intraepithelial lesion(HSIL) after cold knife conization(CKC) for their persistent human papillomavirus(HPV) infection.Methods:The clinical data of 137 patients with HSIL admitted to the hospital from January2021 to December 2022 were collected retrospectively.These patients were treated with CKC and were followed up for1 year after CKC.The HPV persistent infection of these patients after CKC was observed.The vaginal microecology and the serum HLA-G and HLA-E levels of the patients were measured.The correlation between the vaginal microecology and the serum HLA-G and HLA-E levels of the patients and their cervix HPV persistent infection was analyzed.The value of the vaginal microecology and the serum HLA-G and HLA-E levels of the patients for predicting their HPV persistent infection were evaluated.Results:There were 31 patients with the persistent HPV infection(in group A) and 106 cases without the persistent HPV infection(in group B) in 137 patients.There were significant differences in the vaginal pH value,the density and diversity of the vaginal flora and the rate of trichomonas vaginitis of the patients between the two groups.The vaginal microecological imbalance rate of the patients in group A was significantly higher than that of the patients in group B.The levels of the serum HLA-G(19.84±3.53 ng/ml) and HLA-E(75.39±15.83 pg/ml) of the patients in group A were significantly higher than those(16.93±2.96 ng/ml and 68.42±12.51 pg/ml) of the patients in group B.In group A,the levels of serum HLA-G and HLA-E of the patients with vaginal microecological imbalance were significantly higher than those of the patients with normal vaginal microecology(all P<0.05).Spearman correlation analysis showed that the vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients were positively correlated with their postoperative persistent HPV infection(r=0.633,0.529,0.608,all P<0.05).Receiver operating characteristic curve analysis showed that the area under the curve of the vaginal microecological imbalance,the serum HLA-G level,the HLA-E level,and the combined vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients for evaluating their postoperative persistent HPV infection were 0.601,0.773.0.805 and 0.885,respectively(P<0.05).Conclusion:The vaginal microecological imbalance combined with the serum HLA-G and HLA-E levels of the patients with HSIL after CKC has certain predictive value for their postoperative HPV persistent infection.
作者
郑晶晶
张凡
秦晶晶
刘馨雨
辛德梅
ZHENG Jingjing;ZHANG Fan;QIN Jingjing;LIU Xinyu;XIN Demei(Beijing Chuiyangliu Hospital,Beijing,100022)
出处
《中国计划生育学杂志》
2024年第7期1658-1662,共5页
Chinese Journal of Family Planning
基金
内蒙古自治区自然科学基金项目(2019MS08019)。
关键词
宫颈高级别上皮内瘤变
冷刀锥切
人乳头瘤病毒
阴道微生态失衡
人类白细胞抗原-G
人类白细胞抗原-E
持续感染
预测
Cervical high-grade squamous intraepithelial lesion
Cold knife conization
Human papillomavirus
Vaginal microecological imbalance
Human leukocyte antigen-G
Human leukocyte antigen-E
Persistent infection
Prediction
