宫颈癌高危型HPV感染的影响因素及与阴道微生态环境、miR-222、miR-18a、lncRNA SNHG12的相关性

Impact factors of high-risk HPV infection in cervical cancer and its association with vaginal microbiota ecology,miR-222,miR-18a,and lncRNA SNHG12

目的分析宫颈癌高危型人乳头瘤病毒(HPV)感染的影响因素及与阴道微生态环境、血清微小核糖核酸(miR)-222、miR-18a、长链非编码RNA(lncRNA)核仁小RNA宿主基因12(SNHG12)的相关性。方法将2020年12月至2022年12月在南京医科大学附属逸夫医院接受诊断与治疗的184例宫颈癌患者作为研究对象,所有患者在入院时,均接受HPV检测,依据检测结果将患者分为高危型HPV阴性组(105例)与高危型HPV阳性组(79例)。检查、比较两组患者阴道微生态环境;使用Logistic回归分析患者阴道微生态环境同miR-222、miR-18a、lncRNA SNHG12表达水平的相关性。检查、比较两组患者宫颈脱落细胞组织的miR-222、miR-18a、lncRNA SNHG12表达水平;比较两组患者各临床病理特征间的组间差异;通过Spearman分析高危型HPV感染同miR-222、miR-18a、lncRNASNHG12表达水平的相关性;通过Logistic回归分析探寻高危型HPV感染的影响因素。结果高危型HPV阳性组患者在衣原体、细菌性阴道炎发生率、阴道微生态失衡率以及乳酸杆菌异常率与解脲支原体阳性率方面显著高于高危型HPV阴性组(P<0.05);高危型HPV阳性组患者miR-222、miR-18a、lncRNA SNHG12表达水平显著高于高危型HPV阴性组,差异有统计学意义(P<0.05);两组患者在性伴侣数量、分化程度、FIGO分期、HPV病毒负荷量方面比较,差异有统计学意义(P<0.05);高危型HPV感染同miR-222、miR-18a、lncRNA SNHG12表达水平呈现显著正向相关性(P<0.05);患者的衣原体、细菌性阴道炎发生率、阴道微生态失衡率、乳酸杆菌异常率及解脲支原体阳性率同miR-222、miR-18a、lncRNA SNHG12表达水平呈现显著正向相关性(P<0.05);多因素Logistic回归分析结果显示,性伴侣数量、分化程度、FIGO分期、HPV病毒负荷量、阴道微生态环境异常、miR-222、miR-18a、lncRNASNHG12是高危型HPV感染的显著影响因素(P<0.05)。结论性伴侣数量、分化程度、FIGO分期、HPV病毒负荷量、miR-222、miR-18a、lncRNA SNHG12、阴道微生态环境异常是预见高危型HPV感染的重要因素,尤其患者体内微小核糖核酸与小核仁RNA表达水平的增加可能会加重患者病情,值得关注。

Objective To analyze the influencing factors of cervical cancer high-risk human papilloma virus(HPV)infection and the correlation with vaginal microecological environment,serum small ribonucleic acid RNA(miR)-222,miR-18a,long non-coding RNA(lncRNA)nucleolar small RNA host gene 12(SNHG12).Methods 184 cervical cancer patients were diagnosed and treated at Sir Run Run Hospital Affiliated to Nanjing Medical University from December 2020 to December 2022.All patients received HPV test on admission,and the patients were divided into high-risk HPV negative group(105 cases)and high-risk HPV positive group(79 cases).Check and compare the vaginal microecology in two groups.Logistic regression was used to analyze the correlation of miR-222,miR-18a and lncRNA SNHG12.To examine and compare the expression levels of miR-222,miR-18a and lncRNA SNHG12 of the two groups.To compare the differences between the clinicopathological characteristics of the two groups.To analyze the correlation between high-risk HPV infection and miR-222,miR-18a and lncRNA SNHG12 expression levels by Spearman.To explore the influencing factors of high-risk HPV infection by Logistic regression analysis.Results Patients in the high-risk HPV positive group were significantly higher in the incidence of chlamydia,bacterial vaginitis,vaginal microecological imbalance rate,lactobacillus abnormal rate and positive rate of urealyreaplasma than the high-risk HPV negative group(P<0.05).The expression levels of miR-222,miR-18a,and lncRNA SNHG12 were significantly higher than those of the high-risk HPV-negative group.The difference was statistically significant(P<0.05).Both groups were involved in the number of sexual partners,degree of differentiation,FIGO stage,HPV virus load in comparison.The difference was statistically significant(P<0.05).High-risk HPV infection showed a significant positive correlation with the expression levels of miR-222,miR-18a,and lncRNA SNHG12(P<0.05).The incidence of chlamydia,bacterial vaginitis,vaginal microecological imbalance,abnormal rate of Lactobacillus and positive rate of urealyplasma showed significant positive correlation with the expression levels of miR-222,miR-18a and lncRNA SNHG12(P<0.05).Conclusion The number of sexual partners,the degree of differentiation,FIGO stage,HPV virus load,miR-222,miR-18a,lncRNA SNHG12,and abnormal vaginal microecological environment are important factors for predicting high-risk HPV infection,especially the increased expression level of small RNA and small nucleolar RNA in patients may aggravate the patients’condition,which is worth paying attention to.