人乳头瘤病毒感染宫颈病变患者血清miR-212、miR-29b水平及临床意义

Clinical significance of serum miR-212 and mir-29b levels in patients with cervical lesions infected by human papillomavirus

摘要:

目的 探讨人乳头瘤病毒(HPV)感染宫颈病变患者血清微小RNA-212(miR-212)、微小RNA-29b(miR-29b)水平及临床意义。方法 选取2021年6月至2023年6月医院收治的80例HPV感染的宫颈病变患者作为研究对象(病变组),其中CINⅠ级36例，CINⅡ级26例，CINⅢ级18例，选取80例HPV感染的宫颈炎患者作为宫颈炎组，同时选取体检健康的80名女性作为对照组，比较各组血清miR-212、miR-29b水平。血清miR-212、miR-29b水平与宫颈病变级别的关系采用Spearman分析。受试者工作特征曲线(ROC)分析血清miR-212、miR-29b水平对HPV感染的宫颈病变以及CINⅢ级宫颈病变的诊断价值。结果 对照组、宫颈炎组、病变组血清miR-212、miR-29b水平逐渐降低，差异有统计学意义(P<0.05)。CINⅠ级、CINⅡ级、CINⅢ级患者血清miR-212、miR-29b水平逐渐降低，差异有统计学意义(P<0.05)。相关性分析显示，血清miR-212、miR-29b水平分别与宫颈病变级别呈负相关(r=-0.438、-0.460,P<0.05)。ROC分析显示，血清miR-212、miR-29b分别预测发生宫颈病变的曲线下面积(AUC)是0.790、0.806,二者联合预测的AUC为0.886,优于miR-212、miR-29b单独检测(Z=2.672、2.330,P<0.05);血清miR-212、miR-29b分别预测发生CINⅢ级宫颈病变的AUC是0.812、0.826,二者联合预测的AUC为0.927,优于miR-212、miR-29b单独检测(Z=1.883、1.821,P<0.05)。结论 血清miR-212、miR-29b水平在HPV感染的宫颈病变患者中降低，与CIN病变级别呈负相关，且二者对HPV感染的宫颈病变及CINⅢ级宫颈病变有一定的辅助诊断价值。

Abstract:

Objective Toinvestigatethelevelsandtheclinicalsignificanceofserum microRNA-212 (miR-212)and microRNA-29b(miR-29b)inpatientswithhumanpapillomavirus(HPV)infectedcervicallesions.Methods Eightypatients withcervicallesionsdueto HPVinfectionadmittedtothehospitalfrom June2021toJune2023 werecollectedasthe observationsubjects(lesiongroup),including36patientswithcervicalintraepithelialneoplasia(CIN)gradeI,26patients withCINgradeII,and18patientswithCINgradeIII.And80patientswith HPVinfectedcervicitiswereincludedinthe cervicitisgroup,while80healthywomenundergoingphysicalexaminationwereselectedasthecontrolgroup.Thelevelsof serum miR-212and miR-29bineachgroup werecompared.Spearmancorrelationanalysis wasappliedtoanalyzethe relationshipbetweenserum miR-212and miR-29blevelsandthegradeofcervicallesions.Receiveroperatorcharateristic (ROC)curvewasappliedtoanalyzethediagnosticvalueofserum miR-212and miR-29blevelsforHPVinfectedcervical lesionsandCINgradeIIIcervicallesions.Results Thelevelsofserum miR-212andmiR-29binthecontrolgroup,cervicitis group,andlesiongroupgraduallydecreasedinsequence(P<0.05).Thelevelsofserum miR-212andmiR-29binpatients withCINgradeI,CINgradeII,andCINgradeIIIgraduallydecreasedinsequence(P<0.05).Spearmancorrelationanalysis showedthatthelevelsofserum miR-212andmiR-29bwerenegativelycorrelatedwiththegradeofcervicallesions(r=-0.438, -0.460,P<0.05).ROCcurveanalysisshowedthattheareaunderthecurve(AUC)ofserum miR-212andmiR-29bin predictingcervicallesionswas0.790and0.806,respectively.AndtheAUCofthecombinationofthetwoinpredicting cervicallesionswas0.886,whichwasbetterthantheindividualdetectionofmiR-212andmiR-29b(Z=2.672,2.330,P<0.05). TheAUCofserum miR-212andmiR-29binpredictingCINgradeIIIcervicallesionswas0.812and0.826,respectively.And theAUCofthecombinationofthetwoinpredictingCINgradeIIIcervicallesionswas0.927,whichwasbetterthanthe individualdetectionofmiR-212andmiR-29b(Z=1.883,1.821,P<0.05).Conclusion Thelevelsofserum miR-212and miR-29bdecreaseinpatientswith HPVinfectedcervicallesions,whicharenegativelycorrelated withthegradeofCIN lesions.BothhavecertainauxiliarydiagnosticvalueforHPVinfectedcervicallesionsandCINgradeIIIcervicallesions.