摘要
目的探讨高危型人乳头瘤病毒(HR-HPV)感染的早期宫颈癌患者术后NK细胞比例、全身免疫炎症指数(SII)及C反应蛋白与白蛋白比值(CAR)水平特征及其预测宫颈癌复发的价值。方法以2020年5月至2022年12月就诊于新疆医科大学第五附属医院的131例HR-HPV感染的早期宫颈癌术后患者作为研究对象,所有患者均在术后持续随访1年,根据癌症是否复发划分为未复发组(n=88)和复发组(n=43)。收集并对比两组患者一般临床资料及手术病理资料,检测并对比两组手术前后NK细胞比例、SII及CAR水平变化。通过Spearman相关性分析、单因素及多因素Logistic回归分析筛选出HR-HPV感染的早期宫颈癌患者术后复发的危险因素,通过受试者工作特征(ROC)曲线评估各危险因素独立、联合预测癌症复发的价值。结果复发组平均肿瘤大小、腺癌患者比例、术后平均SII、CAR均高于未复发组患者,平均NK细胞比例低于未复发组患者(P<0.05);Spearman相关性分析、单因素及多因素Logistic回归分析表明血清NK细胞比例较低、SII及CAR水平较高均是HR-HPV感染的早期宫颈癌患者术后癌症复发的重要危险因素(P<0.05);ROC分析表明NK细胞比例、SII、CAR独立及联合预测HR-HPV感染的早期宫颈癌术后患者癌症复发的效能均较高,其中联合预测的效能最高(Z=3.674、2.071、2.156,P<0.05)。结论HR-HPV感染的早期宫颈癌患者术后NK细胞比例、SII及CAR水平与癌症复发存在显著相关性,密切监测患者免疫、炎症水平变化对于早期预测癌症复发、改善患者预后具有一定临床意义。
Objective e To investigate the characteristics of NK cell ratio,systemic immune inflammatory index(SII)and C-reactive protein/albumin ratio(CAR)in patients with early cervical cancer infected by high-risk human papillomavirus(HR-HPV)after operation and their predictive value for recurrence.Methods The study included 131 postoperative patients diagnosed with early cervical cancer and infected with HR-HPV who visited the Fifth Afiliated Hospital of Xinjiang Medical University between May 2020 and December 2022.A follow-up period of 1 year was conducted after the operation.Based on the occurrence of cancer recurrence,the patients were categorized into two groups:non-recurrence group(n=88)and recurrence group(n=43).General clinical data and surgical pathological data were collected and compared between the two groups.Additionally,changes in NK cell proportion,SII,and CAR levels before and after the operation were examined and compared.Spearman correlation analysis,univariate and multivariate Logistic regression analysis were used to screen out the risk factors for postoperative recurrence of early cervical cancer patients withHR-HPV infection,and the value of independent and combined prediction of cancer recurrence was evaluated by receiver operatingcharacteristic(ROC)curve.Results The average tumor size,proportion of adenocarcinoma patients,average postoperative SII andCAR in the recurrence group were higher than those in the non-recurrence group,and the average proportion of NK cells was lower thanthat in the non-recurrence group(P<0.05).Spearman correlation analysis,along with univariate and multivariate Logisticregression analysis,demonstrated that a decrease in NK cell proportion and an elevation in SII and CAR levels were significant riskfactors for postoperative recurrence in patients with early cervical cancer infected with high-risk HPV(P<0.05).Additionally,ROCanalysis indicated that NK cell ratio,SII,and CAR exhibited superior predictive ability for cancer recurrence in high-risk HPV infectedpatients,with the combined predictive power reaching the highest level(Z=3.674,2.071,2.156,P<0.05).Conclusion Inpatients with early cervical cancer infected by HR-HPV,a noteworthy association is observed between the ratio of NK cells,SII,andCAR levels and the occurrence of cancer relapse.Regular surveillance of immune and inflammatory markers in patients holds crucialclinical importance in the timely prediction of cancer recurrence,prompt intervention,and enhancement of prognosis.
作者
伊婷
杨静
陈海燕
刘雁林
Yi Ting;Yang Jing;Chen Haiyan;Liu Yanlin(Department of Gynecology,of the Fifth Affiliated Hospital of Xinjiang Medical University,Urumqi Xinjiang 830011,P.R.China)
出处
《中国计划生育和妇产科》
2025年第1期62-66,共5页
Chinese Journal of Family Planning & Gynecotokology
基金
新疆维吾尔自治区自然科学基金项目(项目编号:2020D01C412)。
