摘要
目的 探讨人乳头瘤病毒LI(HPVL1)蛋白、三结构域家族蛋白22(TRIM22)、人表皮生长因子受体-2(HER-2)联合检测在人乳头瘤病毒(HPV)阳性宫颈上皮内瘤变(CIN)中的早期诊断价值.方法 回顾性选取2021年1月至2023年6月承德医学院附属医院就诊的162例薄层液基细胞学(TCT)检查异常且HPV阳性的CIN患者为研究组,另选取同期经组织病理学诊断为正常宫颈组织的138名对象为对照组.免疫组织化学法检测宫颈组织中HPVL1蛋白、TRIM22、HER-2表达.比较对照组、研究组组织中HPVL1蛋白、TRIM22、HER-2表达,并比较不同分级CIN患者HPVL1蛋白、TRIM22、HER-2表达.多因素Logistic回归模型分析CIN发生的影响因素;受试者操作特征(ROC)曲线分析HPVL1蛋白、TRIM22、HER-2表达对CIN的早期诊断价值.结果 研究组组织中HPVL1蛋白及TRIM22蛋白阳性率分别为34.57％、32.72％,均显著低于对照组(74.64％、71.01％),HER-2阳性率为60.49％,显著高于对照组(10.87％),差异均有统计学意义(P＜0.05).CIN Ⅰ级、CIN Ⅱ级和CIN Ⅲ级HPVL1蛋白和TRIM22阳性率呈下降趋势,HER-2阳性率呈上升趋势(P＜0.05).多因素Logistic回归分析结果显示,宫颈组织中HPVL1蛋白、TRIM22及HER-2表达均为CIN的影响因素(OR=5.110、5.231、9.652,P＜0.05).ROC曲线结果显示,HPVL1蛋白表达诊断CIN的曲线下面积(AUC)为0.700,敏感度为65.43％;TRIM22表达诊断CIN的AUC为0.691,敏感度为67.28％;HER-2表达诊断CIN的AUC为0.748,敏感度为60.49％.三者联合诊断CIN的AUC为0.814,显著高于单独诊断的AUC(P＜0.05).结论 宫颈组织中HPVL1蛋白、TRIM22及HER-2表达影响CIN的发生、发展,三者联合对CIN具有较高的诊断价值.
Abstract
Objective To explore the early diagnostic value of combined detection of human papillomavirus LI(HPVL1)protein,tripar-tite motif 22(TRIM22),and human epidermal growth factor receptor-2(HER-2)for human papillomavirus(HPV)positive cervical intraepi-thelial neoplasia(CIN).Methods A total of 162 CIN patients with abnormal thin-layer cytological test(TCT)and HPV positive results who visited the Affiliated Hospital of Chengde Medical University from January 2021 to June 2023 were retrospectively regarded as the study group,an-other 138 cases of normal cervical tissue diagnosed by histopathology were collected as the control group.Immunohistochemical method was applied to detect the expressions of HPVL1 protein,TRIM22,and HER-2 in cervical tissue.The expressions of HPVL1 protein,TRIM22,and HER-2 in the control group and the study group tissues were compared,and the expressions of HPVL1 protein,TRIM22,and HER-2 were compared in patients with different grades of CIN.Multivariate Logistic regression model was applied to analyze the influencing factors of CIN occurrence;the early diagnostic value of HPVL1 protein,TRIM22,and HER-2 expressions for CIN was analyzed by receiver operating characteristic(ROC)curve.Results The positivity rates of HPVL1 protein and TRIM22 protein in the study group were 34.57％and 32.72％,respectively,which were significantly lower than those in the control group(74.64％and 71.01％),and the positivity rate of HER-2 was 60.49％,which was sig-nificantly higher than that in the control group(10.87％),the differences were statistically significant(P＜0.05).The positive rates of HPVL1 protein and TRIM22 in the CIN Ⅰ,CIN Ⅱ,and CIN Ⅲ groups showed a downward trend,while the positive rate of HER-2 showed an upward trend(P＜0.05).The results of multivariate Logistic regression analysis showed that the expressions of HPVL1 protein,TRIM22,and HER-2 in cervical tissue were all influencing factors for CIN(OR=5.110,5.231,9.652;P＜0.05).ROC results showed that the area under the curve(AUC)of HPVL1 protein expression in diagnosing CIN was 0.700,with a sensitivity of 65.43％;the AUC of TRIM22 expression in diag-nosing CIN was 0.691,with a sensitivity of 67.28％;the AUC of HER-2 expression in diagnosing CIN was 0.748,with a sensitivity of 60.49％,the AUC of the combined diagnosis of CIN was 0.814,which was obviously higher than that of the single diagnosis of AUC(P＜0.05).Conclu-sion The expressions of HPVL1 protein,TRIM22,and HER-2 in cervical tissue affect the occurrence and development of CIN,and their com-bination has high diagnostic value for CIN.
基金项目
承德市科学技术研究与发展项目(202006A074)
河北省医学科学研究项目(20231357)
NETL
NSTL
万方数据