四川医学2025，Vol.46Issue(6)：622-627,6.DOI:10.16252/j.cnki.issn1004-0501-2025.06.005
阴道微生态、血清肿瘤标志物预测HR-HPV感染CIN病情进展价值
The Value of Vaginal Microecology and Serum Tumor Markers in Predicting the Progression of High-Risk Human Papillomavirus Infection CIN
摘要
Abstract
Objective To explore predictive value of vaginal microecological characteristics and serum tumor markers for progression of cervical intraepithelial neoplasia(CIN)caused by high-risk human papillomavirus(HR-HPV)infection.Methods A retrospective study was conducted on the clinical data of 112 HR-HPV infected CIN patients admitted to our hospital from Janu-ary 2018 to December 2020.According to whether their condition progressed to cervical cancer,they were divided into a progressive group(n=22)and a non progressive group(n=90).The vaginal microecological characteristics,serum tumor markers[glycan antigen(CA)125,CA19-9,microRNA(miR)-18a,miR-146a]were compared,Pearson analysis of the correlation between the va-ginal microecological characteristics and serum tumor markers was performed,and the receiver operating characteristic(ROC)and area under the curve(AUC)were drawn to analyze whether the indicators have singly or jointly predictive value of HR-HPV infec-tion CIN progression to cervical cancer.Results The Nugent score,ACE index,Chao index,and serum CA125,CA19-9,miR-18a,and miR-146a in the progression group were higher than those in the non-progression group(P＜0.05).Nugent score,ACE index,and Chao index in cervical cancer patients were positively correlated with serum CA125,CA19-9,miR-18a,and miR-146a(P＜0.05).Among serum tumor markers,miR-18a alone had the highest specificity for predicting the progression of HR-HPV-infected CIN to cervical cancer,followed by CA125 alone.Among vaginal microecological characteristics,Nugent score alone had the highest sensitivity for predicting,followed by ACE index alone.The combination of miR-18a,CA125,Nugent score,and ACE index had the highest AUC for predicting the progression of HR-HPV-infected CIN to cervical cancer,with a value of 0.919(95％CI 0.853～0.962),which was significantly higher than that of miR-18a,CA125,Nugent score,and ACE index alone.The optimal sensitivity and specificity were 90.91％and 87.78％,respectively.Conclusion The characteristics of vaginal microecology and abnormali-ties in serum tumor markers have good reference value for predicting the progression of HR-HPV infection from CIN to cervical cancer.However,the combined prediction value of miR-18a,CA125,Nugent score,and ACE index is even higher.关键词
高危型人乳头瘤病毒/宫颈上皮内瘤变/阴道微生态特征/血清肿瘤标志物Key words
high-risk human papillomavirus/cervical intraepithelial neoplasia/characteristics of vaginal microecology/ser-um tumor markers分类
医药卫生引用本文复制引用
温静,朱慧娟,杨华威,吕晓芳..阴道微生态、血清肿瘤标志物预测HR-HPV感染CIN病情进展价值[J].四川医学,2025,46(6):622-627,6.基金项目
2024年度河北省医学科学研究课题计划(编号:20240548) （编号:20240548）
