高危型HPV感染对阴道微生态失衡及miR-146a、miR-155表达的影响

The relationship between HPV infection on vaginal microecological imbalance and the expression of miR-146a and miR-155

目的分析高危型人乳头瘤病毒(HPV)感染与宫颈脱落细胞微小RNA-146a(miR-146a)、微小RNA-155(miR-155)表达水平及阴道微生态失衡的关系。方法选取因宫颈炎于本院就诊的186例患者为研究对象,均进行HPV检测,根据是否感染高危型HPV分为对照组(高危型HPV阴性)112例,观察组(高危型HPV阳性)74例。检测观察组患者HPV感染亚型,比较两组患者阴道微生态改变及阴道微生态平衡状态;采用荧光定量PCR法(qRT-PCR)法检测两组患者宫颈脱落细胞miR-146a、miR-155水平,Spearman法分析高危型HPV感染与宫颈脱落细胞miR-146a、miR-155表达水平及阴道微生态失衡的相关性,以及宫颈细胞miR-146a、miR-155水平与阴道微生态改变的相关性。结果观察组患者高危型HPV感染以HPV16亚型检出率最高,占56.76%,HPV18占18.92%;患者宫颈病变严重程度、阴道微生态失衡率、衣原体、解脲脲原体阳性率、细菌性阴道炎、乳酸杆菌异常率及宫颈脱落细胞中miR-146a、miR-155水平均高于对照组(P<0.05)。两组支原体、滴虫及霉菌阳性率差异均无统计学意义(均P>0.05)。高危型HPV感染与宫颈脱落细胞miR-146a和miR-155水平,以及衣原体、解脲脲原体阳性率、细菌性阴道炎和乳酸杆菌异常率均呈正相关(均P<0.05)。宫颈脱落细胞miR-146a、miR-155水平与衣原体、解脲脲原体阳性率、细菌性阴道炎及乳酸杆菌异常率均呈正相关(均P<0.05)。结论高危型HPV感染可加重阴道微生态环境紊乱,并使宫颈脱落细胞miR-146a、miR-155高表达,增加宫颈病变严重程度。

Objective To analyze the relationship between high-risk human papilloma virus(HPV)infection and the expression levels of microRNA-146 a(miR-146 a)and microRNA-155(miR-155)in cervical exfoliated cells and the vaginal microecological imbalance.Methods A total of 186 patients who were treated in our hospital due to cervicitis were selected as the research objects.All of them were tested for HPV.According to whether they were infected with high-risk HPV,they were divided into 112 cases of control group(negative high-risk HPV)and 74 cases of observation group(positive high-risk HPV).The subtypes of HPV infection in patients were detected,the vaginal microecological changes and the vaginal microecological balance were compared between the two groups,fluorescence quantitative PCR(qRT-PCR)method was used to detect the levels of miR-146 a and miR-155 of cervical exfoliated cells in the two groups.Spearman method was used to analyze the correlation between high-risk HPV infection and the expression levels of miR-146 a,miR-155 in cervical exfoliated cells and vaginal microecological imbalance,and the correlation between cervical cell miR-146 a,miR-155 levels and vaginal microecological changes.Results Among the included research subjects,HPV16 subtype had the highest detection rate of HPV infection,accounting for 56.76%,followed by HPV18,accounting for 18.92%.The severity of cervical lesions,the rate of vaginal microecological imbalance(63.51%),the positive rates of chlamydia(21.62%)and Ureaplasmaurealyticum(79.73%),bacterial vaginitis(33.78%),the abnormal rate of lactobacillus(31.08%),and the levels of miR-146 a(1.58±0.33)and miR-155(1.47±0.31)in cervical exfoliated cells in the observation group were higher than those in the control group(16.07%,6.25%,44.64%,11.61%,5.36%,1.01±0.05,1.02±0.07)(P<0.05),there was no significant difference in the positive rates of mycoplasma,trichomoniasis and mold between the two groups(P>0.05).High-risk HPV infection was positively correlated with the levels of cervical exfoliated cells miR-146 a,miR-155,the positive rates of chlamydia and Ureaplasmaurealyticum,bacterial vaginitis,and the abnormal rate of lactobacilli(r=0.415,0.376,0.307,0.324,0.312,0.341,P<0.05).The levels of miR-146 a and miR-155 in cervical exfoliated cells were positively correlated with the positive rates of chlamydia(r=0.304,0.312)and Ureaplasmaurealyticum(r=0.315,0.328),bacterial vaginitis(r=0.319,0.320),and abnormal rate of lactobacilli(r=0.346,0.357)(P<0.05).Conclusion High-risk HPV infection can aggravate the vaginal microecological environment disorder,increase the expression levels of miR-146 a and miR-155 in cervical exfoliated cells,and increase the severity of cervical lesions.