CIN Ⅲ级患者血清性激素水平与高危型HPV感染的关系

Relationship between serum sex hormone of patients with cervical intraepithelial neoplasia grade III and high-risk human papillomavirus infection

目的 探讨宫颈上皮内瘤变(CIN)Ⅲ级患者血清性激素水平变化及其与高危型人乳头瘤病毒(HR-HPV)感染的关系。方法 选取舟山市妇女儿童医院2019年12月至2022年2月收治的CIN Ⅲ级患者作为观察组,同期体检的健康者作为对照组。2组均进行HR-HPV检测,并采用电化学发光免疫分析方法检测两组血清性激素[促卵泡生成激素(FSH)、催乳素(PRL)、黄体生成素(LH)、雌二醇(E2)、孕酮(P)]水平。比较2组血清性激素水平、HR-HPV总感染率以及不同HR-HPV分型感染率;将观察组中感染HR-HPV的CIN Ⅲ患者计入高危感染组,未感染或感染低危HPV的患者计入未/低危感染组,比较高危感染组、未/低危感染组性激素水平;另比较CIN Ⅲ患者不同HR-HPV分型感染患者的性激素水平。结果 观察组115例CIN Ⅲ级患者和对照组107例健康者比较,观察组血清FSH[(1.93±0.58)mIU/mL]、LH[(1.72±0.51)mIU/mL]的表达水平均低于对照组FSH[(4.75±1.26)mIU/mL]、LH[(6.92±2.18)mIU/mL](P<0.05),血清PRL[(308.18±68.85)mIU/mL]、E2[(293.59±26.66)pmol/L]以及P [(3.15±1.02)nmol/L]的表达水平均高于对照组PRL[(205.24±51.55)mIU/mL]、E2[(176.16±26.54)pmol/L]和P[(1.47±0.34)nmol/L](P<0.05);观察组单一HPV16、HPV18、HPV52分型感染率以及HR-HPV总感染率均高于对照组(P<0.05);高危感染组患者血清FSH[(1.72±0.42)mIU/mL]、LH[(1.64±0.16)mIU/mL]的表达水平均低于未/低危感染组血清FSH[(2.41±0.56)mIU/mL]、LH[(1.90±0.37)mIU/mL](P<0.05),血清E2[(306.46±32.62)pmol/L]的表达水平高于未/低危感染组E2[(264.17±28.12)pmol/L](P<0.05),PRL、P的表达水平比较差异无统计学意义(P>0.05);HPV16型血清LH[(1.72±0.54)mIU/mL]表达水平低于HPV52分型LH[(2.14±0.61)mIU/mL](P<0.05),HPV16型血清E2[(365.07±31.63)pmol/L]表达水平高于HPV18E2[(341.60±25.34)pmol/L](P<0.05),血清FSH、PRL、P的表达水平在不同单一HR-HPV分型感染中比较差异无统计学意义(P>0.05)。结论 CIN Ⅲ级患者血清FSH、LH水平明显降低,而PRL、E2、P水平明显升高,且血清FSH、LH、E2水平与HR-HPV感染有关,检测CIN Ⅲ患者性激素水平有助于判断HR-HPV感染的情况,为临床治疗提供参考。

Objective To investigate the changes in serum sex hormone of patients with cervical intraepithelial neoplasia(CIN)grade III and its relationship with high-risk human papillomavirus(HR-HPV)infection.Methods Patients with CIN III admitted to Zhoushan Women and Children Hospital from December 2019 to February 2022 were selected as the observation group,while healthy individuals who underwent physical examinations in the same period were selected as the control group.In both groups,HR-HPV was inspected,and the levels of serum sex hormones[follicle stimulating hormone(FSH),prolactin(PRL),luteinizing hormone(LH),estradiol(E2)and progesterone(P)]were detected by the enzyme-linked immunosorbent assay.The serum sex hormone levels,total infection rates of HR-HPV,and the infection rates of different HR-HPV subtypes were compared between the two groups.CIN III patients infected with HRHPV in the observation group were enrolled in the high risk infection group,while not infected or infected with low-risk HPV were enrolled in the non/low-risk infection group.The levels of sex hormones between the high risk infection group and non/low-risk infection group were compared.In addition,the sex hormone levels in CIN III patients infected with different HR-HPV subtype were compared.Results Between 115 CIN Grade III patients in the observation group and 107 healthy individuals in the control group,the expression levels of serum FSH(1.93±0.58 mIU/mL)and LH(1.72±0.51 mIU/mL)in the observation group were lower than FSH(4.75±1.26 mIU/mL)and LH (6.92±2.18 mIU/mL) in the control group (P<0.05), whereas PRL(308.18±68.85 mIU/mL), E2(293.59±26.66 pmol/L) andP(3.15±1.02 nmol/L) in the observation group were higher than PRL(205.24±51.55)mIU/mL, E2(176.16±26.54 pmol/L)and P(1.47±0.34 nmol/L) in the control group (P<0.05). The infection rates of HPV16, HPV18 and HPV52 single subtypeand HR-HPV total infection rate in the observation group were higher than those in the control group (P<0.05). Theexpression levels of serum FSH(1.72±0.42 mIU/mL) and LH(1.64±0.16 mIU/mL) in the high risk infection group werelower than FSH(2.41±0.56 mIU/mL) and LH(1.90±0.37 mIU/mL) in the non / low-risk infection group (P<0.05), while E2(306.46±32.62, pmol/L) in the high risk infection group was higher than E2(264.17±28.12 pmol/L) in the non / low-riskinfection group (P<0.05), and there was no statistically significant difference in the expression levels of PRL and P (P>0.05). The expression level of serum LH(1.72±0.54 mIU/mL) in the HPV16 subtype was lower than LH(2.14±0.61 mIU/mL) in the HPV52 subtype (P<0.05), and E2(365.07±31.63 pmol/L) in the HPV16 subtype was higher than E2(341.60±25.34 pmol/L) in the HPV18 subtype (P<0.05). There was no statistically significant difference in the expression levels ofserum FSH, PRL and P in different HR-HPV single subtypes (P>0.05). Conclusions The levels of serum FSH and LH inCIN III patients are significantly lower, while the levels of PRL, E2 and P are significantly higher, and the levels of serumFSH, LH and E2 are related to the infection of HR-HPV. Detection of the sex hormone level of CIN III patients can help todetermine the status of HR-HPV infection, and provide reference for clinical treatment.