HPV E6/E7 mRNA的表达及阴道微生态与宫颈病变的关系

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2=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=...

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

  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.