宫颈脱落细胞mybl2 mRNA表达在绝经后HR-HPV并LSIL/ASC-US患者中的分流价值

Shunt Value of mybl2 mRNA Expression in Exfoliated Cervical Cells in Postmenopausal Patients with HR-HPV and LSIL/ASC-US

目的探讨宫颈脱落细胞mybl2 mRNA表达水平在绝经后细胞学检查为低级别鳞状上皮内病变(LSIL)或无明确诊断意义的不典型鳞状细胞(ASC-US)且合并高危型HPV(HR-HPV)感染患者中的诊断分流价值。方法收集宫颈细胞学筛查为LSIL或ASC-US且合并HR-HPV感染绝经后患者的宫颈脱落细胞共120例,用qPCR检测宫颈脱落细胞的mybl2 mRNA表达水平。所有患者均经阴道镜下宫颈活检术行病理检查,根据病理结果分为宫颈癌(SCC)组(n=4),高级别鳞状上皮内病变(HSIL)组(n=18),LSIL组(n=38),宫颈炎症(NC)组(n=60),比较组间的mybl2 mRNA表达水平;根据HPV感染类型分为16/18型感染组(A组,n=35),16/18型合并其他HR-HPV感染组(B组,n=38),其余HR-HPV感染组(C组,n=47),比较组间的mybl2 mRNA水平。结果SCC组、HSIL组、LSIL组mybl2 mRNA表达水平均明显高于NC组(P<0.05);SCC组、HSIL组mybl2 mRNA表达水平均明显高于LSIL组(P<0.05);SCC组mybl2 mRNA表达水平明显高于HSIL组(P<0.05)。不同HPV感染组间宫颈脱落细胞mybl2 mRNA表达水平比较,A组、B组mybl2 mRNA表达水平明显高于C组(P<0.05),而A组和B组mybl2 mRNA表达水平差异无统计学意义(P>0.05)。结论宫颈脱落细胞的mybl2 mRNA表达水平随宫颈病变程度的加重而升高,且16/18型HPV患者的mybl2 mRNA表达水平明显更高,提示mybl2 mRNA可能作为细胞学为LSIL或ASC-US且合并HR-HPV感染绝经后患者的诊断分流指标,以提高宫颈癌筛查准确率并减少医疗资源浪费。

Objective To explore the diagnostic value of mybl2 mRNA in HR-HPV-positive postmenopausal patients with ASC-US or LSIL cytology.Methods A total of 120 cervical exfoliated cells from postmenopausal patients with cervical cytology screening of LSIL or ASC-US and HR-HPV infection were collected.The mybl2 mRNA expression level of cervical exfoliated cells was detected by qPCR.All patients underwent colposcopic cervical biopsy for pathological examination,and were divided into cervical cancer(SCC)group(n=4),high-grade squamous intraepithelial neoplasia(HSIL)group(n=18),LSIL group(n=38),and cervicitis(NC)group(n=60)according to the pathological results.mybl2 mRNA expression levels were compared between the groups.According to the types of HPV infection,they were divided into 16/18 infection group(group A,n=35),16/18 infection group with other HR-HPV types(group B,n=38),and other HR-HPV infection group(group C,n=47),and mybl2 mRNA levels were compared between the groups.Results mybl2 mRNA expression in cervical exfoliated cells was statistically different(P<0.05)among different cervical biopsy results groups.Upon comparison between different types of HPV infection group,mybl2 mRNA expression levels of groups A and B were much higher than group C(P<0.05),while the difference between group A and group B was not statistically significant(P>0.05).Conclusion The mRNA level of mybl2 in cervical exfoliated cells were found to increase with the severity of cervical lesions,and patients infected with HPV types 16/18 exhibited significantly higher levels of mybl2 mRNA expression,indicating the potential value of mybl2 mRNA as a diagnostic indicator for triage in postmenopausal patients with HR-HPV infection and ASC-US or LSIL cytology,to improve the accuracy of cervical cancer screening and reduce wasting of medical resources.