Stathmin、着丝粒蛋白F预测宫颈高级别鳞状上皮内病变患者宫颈LEEP后复发的价值

Value of Stathmin,centromere protein F in predicting the recurrence of patients with cervical high-grade squamous intraepithelial lesion after cervical LEEP

目的探讨Stathmin、着丝粒蛋白F(CENP-F)预测宫颈高级别鳞状上皮内病变(HSIL)患者宫颈环形电切术(LEEP)后复发的价值。方法回顾性分析120例行宫颈LEEP治疗的宫颈HSIL患者的临床资料。根据随访期间患者的复发情况将其分为复发组和未复发组,比较两组Stathmin、CENP-F阳性表达情况。采用COX回归模型分析宫颈LEEP后复发的影响因素。采用受试者工作特征(ROC)曲线评估Stathmin评分和CENP-F评分预测宫颈LEEP后复发的价值。结果120例宫颈HSIL患者中,有25例(20.83%)患者术后复发。复发组患者Stathmin和CENP-F阳性表达率均高于未复发组(均P<0.05)。多因素COX回归分析结果显示,切缘阳性、高风险人乳头瘤病毒(HPV)种类数≥2种、腺体受累、受累象限>3个、HPV持续感染、Stathmin阳性表达及CENP-F阳性表达均是宫颈HSIL患者宫颈LEEP后复发的影响因素(均P<0.05)。相关分析结果显示,Stathmin评分与CENP-F评分呈正相关(P<0.05)。ROC曲线分析结果显示,Stathmin评分和CENP-F评分预测宫颈HSIL患者宫颈LEEP后复发的曲线下面积分别为0.843和0.865,且当Stathmin评分和CENP-F评分为2.01分和3.03分时,其预测宫颈HSIL患者宫颈LEEP后复发的灵敏度分别为73.28%和75.32%,特异度分别为62.49%和64.18%。结论宫颈HSIL患者宫颈LEEP后复发者Stathmin阳性表达率、CENP-F阳性表达率升高,Stathmin阳性表达、CENP-F阳性表达是宫颈HSIL患者宫颈LEEP后复发的危险因素,二者可作为评估宫颈LEEP后预后的指标。

Objective To explore the value of Stathmin,centromere protein F(CENP-F)in predicting the recurrence of patients with cervical high-grade squamous intraepithelial lesion(HSIL)after cervical loop electrosurgical excision procedure(LEEP).Methods The clinical data of 120 cervical HSIL patients undergoing cervical LEEP therapy were retrospectively analyzed,and they were assigned to recurrence group or non-recurrence group according to the recurrence during follow-up.The positive expressions of Stathmin and CENP-F were compared between the two groups.The influencing factors for the recurrence after cervical LEEP were analyzed by using COX regression model,and the value of Stathmin score and CENP-F score in predicting the recurrence after cervical LEEP was evaluated by employing receiver operating characteristic(ROC)curve.Results Among 120 cervical HSIL patients,25(20.83%)patients reoccurred after operation.The positive expressions of Stathmin and CENP-F were higher in the recurrence group than in the non-recurrence group(all P<0.05).The result of multivariate COX regression analysis revealed that incision edge positive,the number of high risk human papilloma virus(HPV)types≥2,glandular involvement,involved quadrants>3,HPV persistent infection,and Stathmin positive expression and CENP-F positive expression were the influencing factors for the recurrence of cervical HSIL patients after cervical LEEP(all P<0.05).The results of correlation analysis implied that Stathmin score positively correlated with CENP-F score(P<0.05).The results of ROC curve indicated that the areas under the curve of Stathmin score and CENP-F score in predicting the recurrence of cervical HSIL patients after cervical LEEP were 0.843 and 0.865,respectively,when Stathmin score and CENP-F score were 2.01 and 3.03,the sensitivities of them in predicting the recurrence of cervical HSIL patients after cervical LEEP were 73.28%and 75.32%,and the specificities were 62.49%and 64.18%,respectively.Conclusion Stathmin and CENP-F positive expression rates are elevated in the recurrence of cervical HSIL patients after cervical LEEP,and the positive expressions of Stathmin and CENP-F are the risk factors for the recurrence of cervical HSIL patients after cervical LEEP,both of the two can be regarded as evaluated indices for the prognosis after cervical LEEP.