尖锐湿疣差异基因筛选及CXC趋化因子配体10与人乳头瘤病毒分型及复发的相关性研究

Research on the correlation between differentially gene screening,C-X-C motif chemokine 10 and human papilloma virus typing and recurrence in condy loma acuminata

目的探讨CXC趋化因子配体10(CXCL10)在尖锐湿疣(CA)组织中的表达及其与人乳头瘤病毒(HPV)分型及复发的关系。方法采用GEO数据库筛选CA组织和正常组织的差异表达基因。另选取2022年1月至12月无锡市惠山区人民医院收治的120例CA患者(CA组)和40例健康体检者(对照组)作为研究对象,检测其血清CXCL10表达水平。对CA组皮损进行HPV分型检测,采用5-氨基酮戊酸光动力疗法且随访CA组6个月,根据是否复发分为未复发组和复发组。探讨CA患者治疗后复发的独立危险因素及CXCL10表达水平预测CA治疗后复发的临床效能。结果CA组织和正常组织中差异表达基因共184个,其中显著上调58个(包括CXCL10、IGFL1等),显著下调126个(包括MFAP5、PRG4等)。120例CA患者皮损中HPV高危型占64.17%(以HPV16和HPV18感染为主),低危型占37.50%(以HPV6和HPV11感染为主),两种感染占5.83%,两种以上感染占6.67%。与对照组比较,CA组血清CXCL10表达水平显著升高,差异具有统计学意义(P<0.05)。复发组和未复发组疣体数量、疣体直径、合并人类免疫缺陷病毒(HIV)/梅毒、HPV分型、CXCL10表达水平比较,差异具有统计学意义(P<0.05);HPV分型(OR=1.563,P=0.001)、合并HIV/梅毒(OR=1.842,P<0.001)、CXCL10表达(OR=2.061,P<0.001)是CA患者治疗后复发的独立危险因素。血清CXCL10表达水平预测CA治疗后复发的曲线下面积(AUC)为0.911,当CXCL10截断值为26.66 ng/mL时,诊断灵敏度和特异度分别为89.34%和91.56%。结论CA患者血清CXCL10表达水平显著升高,其可作为CA治疗后复发的一项预测指标。

Objective To investigate the expression of C-X-C motif chemokine 10(CXCL10)in condyloma acuminatum(CA)and its relationship with human papilloma virus(HPV)typing and recurrence.Methods The differentially expressed genes between CA tissue and normal tissue were screened in gene expression omnibus(GEO)database.A total of 120 CA patients(CA group)and 40 healthy physical examination participants(control group)admitted to Wuxi Huishan District People′s Hospital from January to December 2022 were enrolled as study objects.The serum expression level of CXCL10 in all individuals were detected.The lesions of CA group were tested for HPV typing.The CA group were treated with 5-aminolevulinic acid photodynamic therapy and followed up for 6 months,and were further divided into non-recurrence group and recurrence group according to lesions recurrence or not.The independent risk factors for recurrence after treatment in CA patients and clinical efficacy of serum CXCL10 expression level in predicting recurrence after treatment was explored.Results There were 184 differentially expressed genes between CA and normal tissues,of which 58 were significantly up-regulated(including CXCL10 and IGFL1)and 126 were significantly down-regulated(including MFAP5 and PRG4).In 120 CA patients with lesions,the high-risk HPV typing accounted for 64.17%(mainly including HPV16 and HPV18 infections),low-risk HPV typing accounted for 37.50%(mainly including HPV6 and HPV11 infections),two HPV infections accounted for 5.83%,and more than two HPV infections accounted for 6.67%.Compared with control group,the serum expression level of CXCL10 in CA group was significantly higher,with statistical significance(P<0.05).There were significant differences in the number of warts,the diameter of warts,complicated with human immunodeficiency virus(HIV)/syphilis,HPV typing and CXCL10 expression levels between the non-recurrence group and recurrence group(P<0.05).The HPV typing(OR=1.563,P=0.001),complicated with HIV/syphilis(OR=1.842,P<0.001)and CXCL10 expression(OR=2.061,P<0.001)were independent risk factors for recurrence after treatment in CA patients.The area under curve(AUC)of the serum expression level of CXCL10 in predicting the incidence of recurrence after CA treatment was 0.911,and when the CXCL10 cut-off value was 26.66 ng/mL,the diagnostic sensitivity and specificity were 89.34%and 91.56%,respectively.Conclusions The serum expression level of CXCL10 in CA patients was significantly increased,which can be used as a predictor of recurrence after CA treatment.