Correlation between vaginal microecological characteristics and tumor markers in patients with HR-HPV-infected CIN and value of combined detection
Objective To explore the correlation between vaginal microecology and tumor markers in patients with high-risk human papillomavirus(HR-HPV)infection of cervical intraepithelial neoplasia(CIN),as well as the value of combined detection.Methods A total of 150 cases of HR-HPV CIN patients in Shijiazhuang Maternal and Child Health Care Hospital from January 2020 to January 2023 were se-lected as the study group,among which there were 50 cases of CIN grade Ⅰ,50 cases of CIN grade Ⅱ,50 cases of CIN grade Ⅲ,and 150 cases of women who had physical examination in the same period were selected as the control group.The levels of vaginal microecology[pH value,N-acetylglucosidase(NAG),β-glucuronidase(GUS),sialidase(SNA),leukocyte esterase(LE),hydrogen peroxide(H2O2)]and tumor markers[Serum carcinoembryonic antigen(CEA),squamous epithelial cell carcinoma antigen(SCCA),glycoantigen 199(CA199),glycoantigen 125(CA125)]were compared between the two groups,the correlation between vaginal microecology and tumor markers was analyzed,and the diagnostic value of vaginal microecology and tumor markers and the relationship with pathological grading were evaluated..Results The pH value,NAG,GUS,SNA,LE,H2O2 positive rate,vaginal microecological imbalance rate,serum CEA,SCCA,CA199,and CA125 levels in the study group were higher than those in the control group(P<0.05).The positive rates of pH,NAG,GUS,SNA,LE,H2O2,vaginal microecologi-cal imbalance were positively correlated with serum CEA,SCCA,CA199,and CA125(P<0.05).The risk of HR-HPV CIN in patients with vagi-nal microecological imbalance and positive serum CEA,SCCA,CA199,or CA125 expression was 3.850 times(95%CI:2.696～5.498),2.603 times(95%CI:2.155～3.143),4.401 times(95%CI:3.239～5.961),4.896 times(95%CI:3.588～6.682),and 2.272 times(95%CI:1.886～2.738)higher than that in patients with normal vaginal microecology and negative serum CEA,SCCA,CA199,or CA125 expression.The area under the curve of vaginal microecological imbalance combined with serum CEA,SCCA,CA199,and CA125 for diagnosing HR-HPV CIN was 0.930(95%CI:0.885～0.961),which was greater than each individual diagnosis.The rate of vaginal microecological imbalance,serum CEA,SCCA,CA199,and CA125 levels in patients with CIN Ⅲ were higher than those in patients with CIN Ⅱ and I(P<0.05).There was a positive correla-tion between vaginal microecological imbalance and serum CEA,SCCA,CA199,and CA125(P<0.05).Conclusion The vaginal microbiota imbalance in HR-HPV CIN patients is closely related to serum CEA,SCCA,CA199,and CA125 levels,and all are significantly correlated with the risk of CIN occurrence and pathological grading.The combined diagnostic value is reliable and can provide guidance for clinical diag-nosis and treatment.
High-risk human papillomavirusCervical intraepithelial neoplasiaVaginal microecological characteristicsTumor mark-ersPathological gradeDiagnostic value
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