细胞学指标与宫颈癌HPV亚型的相关性研究

Study on the correlation between cytological indicators and HPV subtypes in cervical cancer

摘要

目的 探讨宫颈癌相关人乳头瘤病毒(HPV)亚型与细胞学指标变化的关联性,为宫颈癌的早期诊断和防治提供更精准依据。方法 选取2021年1月至2023年12月期间于南京市高淳人民医院收治的宫颈癌患者为研究对象.采用聚合酶链反应(PCR)技术对患者进行HPV亚型检测,确定高危型(包括HPV16、18、31、33等)和低危型(包括HPV6、11等)HPV感染情况.同时,进行细胞学检查,观察细胞形态(包括细胞核直径、形状等)、染色质分布(通过均匀度评分进行评估)以及细胞异型性(以异型性指数衡量)等细胞学指标变化.运用Spearman方法分析HPV亚型与细胞核形态、染色质分布、细胞异型性的相关性.对HPV亚型、患者年龄、生育史等因素进行Logistic多因素回归分析以确定影响因素。结果 高危型HPV感染患者细胞核平均直径13.5μm,70%形状不规则;染色质分布均匀度3.5分,85%不均;细胞异型性指数1.9.低危型细胞核直径9.2μm,40%稍不规则;均匀度6.8分;异型性指数1.3.正常细胞相应指标则更优.Spearman相关性分析显示,高危型HPV感染与细胞核形态异常、染色质分布不均匀度、细胞异型性指数升高呈显著正相关(r=0.82、0.76、0.85,P<0.05).Logistic多因素回归分析表明,高危型HPV感染是影响细胞学指标异常的重要因素之一(OR=1.46~1.73,P<0.05)。结论 高危型HPV感染与细胞学异常密切相关,特定的HPV亚型可能预示着特定的细胞学改变.通过对HPV亚型和细胞学指标的联合检测,可以提高宫颈癌的早期诊断准确性,为宫颈癌的防治提供重要参考.

Abstract

Objective To investigate the correlation between human papillomavirus (HPV) subtypes and cytological indicators associated with cervical cancer, and to provide a more accurate basis for the early diagnosis and prevention of cervical cancer. Methods Patients with cervical cancer admitted to Nanjing Gaochun People's Hospital from January 2021 to December 2023 were selected as the study subjects. Polymerase chain reaction (PCR) technology was used to detect HPV subtypes in patients to determine the infection status of high-risk types (including HPV16, 18, 31, 33, etc.) and low-risk types (including HPV6, 11, etc.) HPV. At the same time, cytological examinations were performed to observe changes in cytological indicators such as cell morphology (including nuclear diameter, shape, etc.), chromatin distribution (assessed by uniformity score), and cell atypia (measured by atypia index). The Spearman method was used to analyze the correlation between HPV subtypes and nuclear morphology, chromatin distribution, and cell atypia. Logistic multivariate regression analysis was performed to determine the influencing factors of HPV subtype, patient age, and reproductive history. Results The average diameter of the nucleus in patients with high-risk HPV infection was 13.5μm, 70% of which were irregular in shape; the uniformity of chromatin distribution was 3.5 points, 85% were uneven; and the cell atypia index was 1.9. The diameter of the nucleus of low-risk cells was 9.2μm, 40% were slightly irregular; the uniformity was 6.8 points; and the atypia index was 1.3. The corresponding indicators of normal cells were better. Spearman correlation analysis showed that high-risk HPV infection was significantly positively correlated with abnormal nuclear morphology, uneven chromatin distribution, and increased cell atypia index (r=0.82, 0.76, 0.85, P<0.05). Logistic multivariate regression analysis showed that high-risk HPV subtype was one of the important factors affecting abnormal cytological indicators (OR=1.46-1.73, P<0.05). Conclusion High-risk HPV infection is closely related to cytological abnormalities, and specific HPV subtypes may indicate specific cytological changes. The combined detection of HPV subtypes and cytological indicators can improve the accuracy of early diagnosis of cervical cancer and provide an important reference for the prevention and treatment of cervical cancer.

关键词

宫颈癌 / HPV / 细胞学指标 / 早期诊断 / 风险评估

Key words

cervical cancer / human papillomavirus / cytological index / early diagnosis / risk assessment

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基金资助

江苏大学2021年度临床医学科技发展基金(JLY2021177)