子宫颈HPV感染与MCM2表达及阴道环境因素的相关性分析

Correlation of the expression of MCM2 and the vaginal environment factors with the infection of HPV

目的:探讨子宫颈人乳头瘤病毒(HPV)感染与微小染色体维持蛋白2(MCM2)表达及阴道环境因素的相关性。方法:选择2013年12月至2015年12月在本院接受宫颈液基薄层细胞学检测和人乳头瘤病毒分型检查的204例宫颈病变患者作为本次研究对象,进行MCM2免疫细胞化学检测,比较MCM2免疫细胞检测、HPV检测及两者联合检测在宫颈癌前病变中的价值,并对HPV感染(高危型及低危型)和HPV阴性患者与阴道环境因素(阴道分泌物p H值、假丝酵母菌、阴道菌群情况和阴道清洁度情况)相关性进行分析。结果:随着宫颈病变不断加重,HPV感染阳性率和MCM2表达率均有所升高,MCM2表达与HPV的感染之间存在一致性(χ~2=23.818 8,P=0.000 6);MCM2免疫细胞检测、HPV检测及两者联合检测在宫颈上皮肉瘤变Ⅰ级(CINⅠ)及慢性炎症和CINⅡ及以上病变的筛查中差异均有统计学意义(P<0.05);对CINⅡ及以上病变的筛查,MCM2免疫细胞检测与HPV检测及MCM2免疫细胞联合HPV检测相比,差异均无统计学意义(P>0.05),HPV检测与MCM2免疫细胞联合HPV检测相比,差异具有统计学意义(P<0.05);HPV感染(高危型及低危型)患者与HPV呈阴性的患者在阴道p H值、阴道菌群情况和阴道清洁度间差异均有统计学意义(P<0.05),在假丝酵母菌间差异无统计学意义(P>0.05)。结论:MCM2表达可作为宫颈癌前病变筛查标志物,MCM2免疫细胞化学检测效果比HPV检测更好。此外,HPV感染与患者阴道环境因素之间具有相关性。

Objective： To analyze the correlation of the expression of minichromosome maintenance protein 2 （MCM2） and the vaginal environment factors with the infection of human papillomavirus （HPV）. Methods ： 204 patients with cervical lesions received thinprep liquid-based cytology test and HPV typing test in our hospital from December 2013 to December 2016. And MCM2 immunocytochemieal test was performed. Those results were compared. The relationship between HPV infection, negative HPV infection and vaginal environment （Candida Albicans, Trichomonas vaginalis, vagina bacteria colony, cleaning degree of vagina and the pH of vaginal discharge） were compared and analyzed. Results：The positive expression rate of HPV and MCM2 were improved with the continuous increase of cervical lesions. The HPV infection and MCM2 expression had significant consistency （x^2 = 23. 818 8 ,P = 0. 000 6）. The results of MCM2 immunocytochemical test, HPV test and the combination of the two in screening the cervical precancerous lesions both had significant difference （ P 〈 0.05 ）. The results of MCM2 immunocytochemical test and HPV test for detecting CIN Ⅱ or worse had no significant difference （P 〉 0.05 ）, the results of MCM2 immunocytochemical test and the combination test also had no significant difference （ P 〉 0.05 ）. The results of HPV test and the combination test for detecting the CIN Ⅱ or worse had significant differences （P 〈 0.05）. HPV infection patients and patients with negative HPV had significant differences in vaginal pH, vagina bacteria colony and vaginal cleanness level （ P 〈 0.05 ）. And no significant differences were found in candida infection （ P 〉 0.05 ）. Conclusion： MCM2 can serve as a useful marker in screening the cervical precancerous lesions. The MCM2 immunocytochemical test is better than HPV test.HPV infection and vaginal environment have no obvious relevance.