HPV L1壳蛋白联合高危HPV分型、CA125、SCC-Ag在宫颈癌诊断中的应用价值

The value of HPV L1 capsid protein combined with high-risk HPV typing,CA125,SCC-Ag in the diagnosis of cervical cancer

目的 探讨人乳头瘤病毒(HPV)L1壳蛋白联合HPV分型、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC-Ag)在宫颈癌诊断中的应用价值。方法 选取2021年1月至2022年12月在北京市垂杨柳医院治疗的宫颈疾病患者214例,其中宫颈癌患者45例,高度宫颈上皮内瘤变(CINⅡ和CINⅢ型)患者56例,低度CIN病变(CINⅠ)患者47例,宫颈炎患者66例,分析各患者HPV L1壳蛋白、高危HPV分型、血清CA125和SCC-Ag的差异。结果 低度CIN低病变组HPV L1壳蛋白阳性率明显高于其他患者(P <0.05);宫颈炎和高度CIN病变HPV L1壳蛋白阳性率明显高于宫颈癌(P <0.05)。随着宫颈病变程度加重,高危HPV阳性率明显升高(P <0.05),血清CA125和SCC-Ag明显升高(P <0.05)。HPV L1壳蛋白联合高危HPV分型、CA125、SCC-Ag诊断的ROC曲线下面积为0.630,诊断价值不高。结论 HPV L1壳蛋白、高危HPV分型、血清CA125和SCC-Ag在不同宫颈病变患者中有明显差异,其中高危HPV分型、血清CA125在诊断宫颈癌方面有一定价值,HPV L1壳蛋白联合高危HPV分型、CA125、SCC-Ag诊断价值较低。

Objective To explore the value of human papillomavirus(HPV) L1 capsid protein combined with HPV typing,carbohydrate antigen 125(CA125) and squamous cell carcinoma antigen(SCC-Ag) in the diagnosis of cervical cancer.Methods A total of 214 patients with cervical lesions who were treated in our hospital from January 2021 to December 2022 were selected,including 45 patients with cervical cancer,56 patients with high cervical intraepithelial neoplasia(CIN) lesions(CIN Ⅱ and CIN Ⅲ),47 patients with low CIN lesions(CINⅠ),and 66 patients with cervicitis.We analyzed the differences in HPV L1 capsid protein,high-risk HPV typing,serum CA125 and SCC-A.Results The positive rate of HPV L1 in low-grade CIN group was significantly higher than that in other patients(P < 0.05).The positive rates of HPV L1 in cervicitis and high-grade CIN were significantly higher than those in cervical cancer(P < 0.05).With the severity of cervical lesions,the positive rate of high-risk HPV increased significantly(P < 0.05).Serum CA125 and SCC-Ag levels also significantly increased with worsening cervical lesions(P <0.05).The area under the Receiver operating characteristic curve for the diagnosis of cervical cancer using HPV L1 capsid protein with highrisk HPV typing,CA125,SCC-Ag diagnosis was 0.630,indicating low diagnostic value.Conclusions HPV L1 capsid protein,high-risk HPV typing,serum CA125 and SCC-Ag showed significant differences among patients with different cervical diseases.Among these markers,high-risk HPV typing and serum CA125 displayed certain diagnostic value in the diagnosis of cervical cancer,while HPV L1 capsid protein combined with high-risk HPV typing,CA125 and SCC-Ag had limited diagnostic value for cervical cancer.