The changes of vaginal microecology and serum tumor marker in CIN and cervical cancer patients with HR-HPV infection and their predictive value for cervical cancer
Objective To analyze the changes of vaginal microecology,serum tumor marker in cervical cancer(CC)and CIN patients with high-risk human papillomavirus(HR-HPV)infection and their predictive value for cervical cancer.Methods A total of 50 patients with CIN infected with HR-HPV from Shijiazhuang City Maternal and Child Health Care Hospital from July 2022 to September 2023 were selected as CIN group,and 50 patients with HR-HPV infected CC in the same age group were selected as CC group.The basic data,vaginal microecological imbalance rate and serum tumor marker level of the two groups were compared,and the vaginal microecological imbalance rate and serum tumor marker level of patients with different CIN grades in the CIN group were compared,and the correlation between the vaginal microecological imbalance rate and serum tumor marker level and CIN grade was analyzed.The factors influencing the progression of CIN to CC and the value of vaginal microecological imbalance and serum tumor markers in predicting the progression of CIN to CC were analyzed.Results The proportion of spontaneous abortion≥1 time(38.00％),the proportion of menarche＞13 years old(78.00％)and the rate of vaginal microecological imbalance(68.00％)in CC group were higher than those in CIN group(14.00％,50.00％,30.00％)(P＜0.05).The serum levels of carbohydrate antigen 199(CA199),squamous cell carcinoma antigen(SCCA),carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)in CC group were higher than those in CIN group(P＜0.05).The vaginal microecological imbalance rate,serum SCCA,CEA,CA199 and CA125 levels of CIN grade Ⅲ patients in CIN group were higher than those of grade Ⅱ and grade Ⅰ patients,and those of grade Ⅱ patients were higher than those of grade Ⅰ patients(P＜0.05).Vaginal microecological imbalance rate,serum SCCA,CEA,CA199,CA125 levels were positively correlated with CIN grade(P＜0.05).Spontaneous abortion ≥1 time,menarche age＞13 years,vaginal microecological imbalance,serum SCCA,CEA,CA199,CA125 levels were all independent risk factors for CIN progression to CC(P＜0.05).The area under the curve(AUC)of vaginal microecological imbalance,serum SCCA,CEA,CA199,and CA125 for predicting the progression of CIN to CC were 0.706,0.750,0.784,0.828,and 0.724,respectively,and the combined prediction had the highest AUC of 0.901(P＜0.05).The combination of vaginal microecological imbalance,serum SCCA,CEA,CA199,and CA125 had good clinical utility in predicting the progression of CIN to CC.Conclusion Vaginal microecological imbalance,serum SCCA,CEA,CA199,and CA125 are all independent risk factors for the progression of CIN to CC.The combined detection of vaginal microecology,serum SCCA,CEA,CA199,and CA125 has high predictive power and good clinical utility for the progression of CIN to CC.
万方数据
维普
