宫颈癌患者血清miR-21、miR-155水平与阴道微生态的相关性

doi:10.3969/j.issn.1673-8640.2025.03.013

摘要/Abstract

摘要：

目的分析宫颈癌（CC）患者血清miR-21、miR-155水平与阴道微生态的相关性。方法选取2020年1月—2021年12月苏州市立医院（北区）CC患者68例（CC组）、宫颈上皮内瘤变（CIN）患者60例（CIN组）、体检健康女性60名（对照组）。采用实时荧光定量聚合酶链反应（PCR）检测血清miR-21、miR-155水平；采用涂片镜检、革兰染色、阴道微生物功能学检测受试者阴道微生态相关指标；比较各组各项指标差异。采用Pearson相关分析评价CC组血清miR-21与miR-155的相关性；采用Spearman相关分析评价血清miR-21、miR-155与阴道微生态相关指标的相关性。结果与对照组比较，CIN组和CC组血清miR-21、miR-155水平均升高（P<0.05）；CC组血清miR-21、miR-155水平和人乳头瘤病毒（HPV）16/18阳性率均明显高于CIN组（P<0.05）。CC组阴道菌群密集度（1级或4级）、需氧菌性阴道炎（AV）、细菌性阴道病（BV）患者所占比例高于CIN组（P<0.05）；CIN组和CC组阴道菌群多样性（1级或4级）、清洁度（3~4度）、pH值>4.5、滴虫阴道炎（TV）、H₂O₂阳性、白细胞酯酶阳性患者所占比例差异无统计学意义（P>0.05）。CC组血清miR-21与miR-155呈正相关（r=0.524，P<0.001）；血清miR-21、miR-155水平与HPV16/18型阳性率、阴道菌群密集度（1级或4级）、AV、BV均呈正相关（P<0.001）。结论 CC患者血清miR-21、miR-155表达上调，2项指标与HPV16/18型感染、阴道微生态变化具有一定的相关性。

关键词: miR-21, miR-155, 阴道微生态, 宫颈癌

Abstract:

Objective To investigate the correlation of serum miR-21 and miR-155 levels and vaginal microecological changes in patients with cervical cancer （CC）. Methods From January 2020 to December 2021，68 patients with CC from Suzhou Municipal Hospital（North District）were enrolled as CC group，60 patients with cervical intraepithelial neoplasia （CIN） were enrolled as CIN group，and 60 healthy subjects were enrolled as control group. Quantitative real-time polymerase chain reaction （PCR） was used to determine the levels of serum miR-21 and miR-155. Smear microscopy，Gram staining smears and vaginal microbial functional assay were used to determine vaginal microecological indicators. Pearson correlation was used to analyze the correlation of serum miR-21 and miR-155 in CC group. Spearman correlation was used to analyze the correlation between serum miR-21，miR-155 and vaginal microecological indicators. Results Compared with control group，serum miR-21 and miR-155 levels were higher in CIN and CC groups（P<0.05）. The levels of serum miR-21 and miR-155 and the positive rate of human papillomavirus（HPV）16/18 in CC group were higher than those in CIN group（P<0.05）. The proportions of vaginal flora density（grade 1 or 4），aerobic vaginitis（AV）and bacterial vaginosis（BV）in CC group were higher than those in CIN group（P<0.05），and there was no statistical significance in the proportions of vaginal flora diversity （grade 1 or 4），cleanliness（grade 3-4），pH>4.5，trichomonal vaginitis（TV），positive H₂O₂ and positive leukocyte esterase between CIN and CC groups（P>0.05）. Serum miR-21 and miR-155 levels in CC group were positively correlated（r=0.524，P<0.001）. Serum miR-21 and miR-155 levels were positively correlated with HPV16/18 positive rate，vaginal flora density（grade 1 or 4），AV and BV（P<0.001）. Conclusions The expressions of serum miR-21 and miR-155 in CC patients are up-regulated，and they have a certain correlation with HPV16/18 infection and vaginal microecological changes.

Key words: MiR-21, MiR-155, Vaginal microecology, Cervical cancer

中图分类号:

R446.7

周颖, 徐颖, 邱剑萍. 宫颈癌患者血清miR-21、miR-155水平与阴道微生态的相关性[J]. 检验医学, 2025, 40(3): 278-282.

ZHOU Ying, XU Ying, QIU Jianping. Correlation of serum miR-21 and miR-155 levels and vaginal microecological changes in patients with cervical cancer[J]. Laboratory Medicine, 2025, 40(3): 278-282.

图/表 5

参考文献 25

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组别	例数	年龄/岁	体重指数/（kg·m^-2）	孕次/次	产次/次	宫颈长度/cm
CC组	68	48.25±7.26	23.04±2.21	2.50±0.45	1.75±0.35	4.26±0.59
CIN组	60	48.80±7.18	22.76±2.29	2.60±0.41	1.85±0.39	4.13±0.68
对照组	60	48.45±7.35	22.55±2.41	2.60±0.42	1.70±0.45	4.02±0.75
统计值		0.093	0.733	1.185	2.230	2.041
P值		0.912	0.482	0.308	0.111	0.133

组别	例数	年龄/岁	体重指数/（kg·m^-2）	孕次/次	产次/次	宫颈长度/cm
CC组	68	48.25±7.26	23.04±2.21	2.50±0.45	1.75±0.35	4.26±0.59
CIN组	60	48.80±7.18	22.76±2.29	2.60±0.41	1.85±0.39	4.13±0.68
对照组	60	48.45±7.35	22.55±2.41	2.60±0.42	1.70±0.45	4.02±0.75
统计值		0.093	0.733	1.185	2.230	2.041
P值		0.912	0.482	0.308	0.111	0.133

组别	例数	miR-21	miR-155	HPV16/18型阳性率/[%（例）]
CC组	68	1.87±0.49^*#	1.72±0.42^*#	73.53（50）
CIN组	60	1.03±0.08^*	1.02±0.09^*	35.00（21）
对照组	60	0.62±0.11	0.71±0.13
统计值		282.384	240.839	19.157
P值		<0.001	<0.001	<0.001

组别	例数	miR-21	miR-155	HPV16/18型阳性率/[%（例）]
CC组	68	1.87±0.49^*#	1.72±0.42^*#	73.53（50）
CIN组	60	1.03±0.08^*	1.02±0.09^*	35.00（21）
对照组	60	0.62±0.11	0.71±0.13
统计值		282.384	240.839	19.157
P值		<0.001	<0.001	<0.001

组别	例数	阴道菌群密集度（1级或4级）/[例（%）]	阴道菌群多样性（1级或4级）/[例（%）]	清洁度（3~4度）/ [例（%）]	AV/ [例（%）]	BV/ [例（%）]	TV/ [例（%）]	pH值>4.5/ [例（%）]	H₂O₂阳性/[例（%）]	白细胞酯酶阳性/ [例（%）]
CC组	68	54 （79.41）	32 （47.06）	52（76.47）	46（67.65）	50（73.53）	4 （5.88）	49（72.06）	45（66.18）	37（54.41）
CIN组	60	35 （58.33）	25 （41.67）	46（76.67）	28（46.67）	33（55.00）	2 （3.33）	41（68.33）	39（65.00）	30（50.00）
统计值		6.685	0.375	0.001	5.753	4.801	0.069	0.212	0.020	0.249
P值		0.010	0.540	0.979	0.016	0.028	0.793	0.645	0.889	0.618