Relationship between cervical lesions and inflammatory factors in vaginal lavage fluid and establishment of nomogram prediction model for cervical carcinogenesis
OBJECTIVE To analyze the differences in helper T(Th)cells and regulatory T(Treg)cells of vaginal lavage fluid of the patients with different degree of cervical lesions and establish the nomogram prediction model for cervical carcinogenesis.METHODS Totally 200 patients with high-risk human papillomavirus(HR-HPV)16 infection who were treated in Xingtai People's Hospital from Jan 2022 to Dec 2022 were recruited as the research subjects and were divided into the cervical cancer group with 35 cases and the non-cervical cancer group with 165 cases according to the status of cervical cancerization.The patients of the non-cervical cancer group were divided into the no lesion group with 52 cases,the low-grade squamous intraepithelial lesions(LSIL)group with 58 cases and the high-grade squamous intraepithelial lesions(HSIL)group with 55 cases according to the degree of cervical lesion.Meanwhile,100 healthy people who received physical examination were chosen as the control group.The expression levels of Th and Treg cytokines in vaginal lavage fluid were compared among the groups of subjects.The nomogram model for prediction of cervical cancerization was established by R software,and the efficiency of the model in prediction of cervical cancerization was analyzed by means of receiver operating characteristic(ROC)curves.RESULTS There were significant differences in the expression levels of tumor necrosis factor-α(TNF-α),transforming growth factor-β(TGF-β),interferon-γ(IFN-γ),interleukin(IL)-2,IL-6,IL-10 and IL-17 in vaginal lavage fluid among the 5 groups of subjects(P＜0.05).With the progress of disease,the IL-6,IL-10,IL-17 and TGF-β showed upward trends,while the TNF-α,IFN-γ and IL-2 showed downward trends(P＜0.05).The levels of IL-6,IL-10,IL-17 and TGF-β of the cervical cancer group were significantly higher than those of the non-cervi-cal cancer group,while the levels of TNF-α,IFN-γ and IL-2 of the cervical cancer group were significantly lower than those of the non-cervical cancer group(P＜0.05).ROC curve analysis showed that the area under curve(AUC)of the nomogram model was 0.818(95％CI 0.736-0.900)in prediction of the cervical cancerization,with the sensitivity 77.14％,the specificity 78.79％.CONCLUSION The Th and Treg cytokines in vaginal lavage fluid are closely associated with the cervical cancerization.The nomogram model established based on the cytokines has favorable efficiency in prediction of risk for cervical cancerization.
High-risk human papillomavirusCervical lesionCervical cancerVaginal lavage fluidHelper T cellRegulatory T cellCytokineNomogram
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