HPV和P16蛋白对HSIL患者诊断价值及预后疗效分析

The diagnostic value of HPV and P16 protein in patients with HSIL and prognosis

目的:探讨HPV和P16蛋白水平对HSIL患者的诊断价值和预后疗效的评估价值,以期为临床诊断和评估HSIL患者预后提供参考。方法:选取我院收治的行手术治疗的HSIL患者,所有患者术前常规检测HPV和P16蛋白,所有患者术后随访1年,根据术后1年疾病是否进展将患者分为进展组和静止组,分析比较两组术前HPV和P16蛋白水平;采用受试者工作曲线(ROC工作曲线)分析HPV对HSIL的诊断价值。分析比较两组术后HPV和P16蛋白水平。结果:LEEP术后高危型HPV-DNA定量水平显著低于术前水平,差异具有统计学意义(P<0.01)。患者术前P16蛋白综合计分高于手术后水平,差异具有统计学意义(P<0.01)。术后进展组有21例,进展组术后1年内平均HPV-DNA含量高于对照组,差异具有统计学意义(P<0.05)。进展组术后P16蛋白水平高于静止组,差异具有统计学意义(P<0.05)。进展组术前HPV-DNA含量和P16蛋白水平高于静止组,差异具有统计学意义(P<0.01)。ROC曲线分析显示,以2.441为截点值,HPV-DNA预测HSIL患者术后1年复发的敏感性为95.12%,特异性为76.16%,曲线下面积为0.878;以7.4为截点值,P16综合计分预测HSIL患者术后1年复发的敏感性为71.95%,特异性为66.67%,曲线下面积为0.753。复发组HPV-DNA含量和P16蛋白水平间呈现显著正相关关系,具有统计学意义(P<0.01)。结论:LEEP手术可降低HSIL患者术后HPV和P16蛋白含量,HPV和P16蛋白含量对于HSIL早期诊断和术后疾病进展的预测具有较高价值。

Objective: To investigate the diagnostic value and prognostic value of HPV and P16 protein in patients with HSIL and to provide a reference for the clinical diagnosis and assessment of the prognosis of patients with HSIL. Methods: The surgical treatment of HSIL patients from January 2013 to January 2015 in our hospital were selected. All patients were routinely tested for HPV and P16 protein, and all patients were followed up for 1 year. Patients were divided into progressive group and quiescent group according to whether the disease progressed one year after surgery. Preoperative HPV and P16 protein levels were compared between the two groups. Using receiver operating curve (ROC curve) Analysis of HPV diagnostic value of HSIL. The levels of HPV and P16 protein in the two groups were analyzed and compared. Results: The quantitative level of high-risk HPV-DNA after LEEP was significantly lower than that before operation (0.83 ± 0.22 vs 2.06 ± 0.91, t =13.330, P <0.01). The level of P16 protein in preoperative patients was higher than that before operation, and the difference was statistically significant (6.9±3.0 vs 4.5±2.8, t =4.337, P <0.01). There were 21 patients in the postoperative progression group, and the average HPV-DNA content in the patients in the progression group was higher than that in the control group within one year after operation. The difference was statistically significant ( P <0.05). The P16 protein level in patients in advanced group was significantly higher than that in resting group ( P <0.05). Preoperative HPV-DNA levels and P16 protein levels in patients with progressive disease were significantly higher than those in still group ( P <0.01). ROC curve analysis showed that the cut-off value of 2.441, HPV-DNA prediction of HSIL patients one year after the recurrence of the sensitivity was 95.12%, the specificity was 76.16%, under the curve area of 0.878;7.4 cut-off value, P16 The predictive value of HSIL patients recurrence after 1 year was 71.95%, specificity was 66.67%, and the area under the curve was 0.753. The recurrence group HPV-DNA content and P16 protein level showed a significant positive correlation, with statistical significance ( r =0.816, P <0.01). Conclusions: LEEP can reduce the postoperative levels of HPV and P16 protein in patients with HSIL. The HPV and P16 protein levels are of high value for the early diagnosis of HSIL and the prediction of postoperative disease progression.