Serum sex hormone levels in patients with cervical intraepithelial neoplasia grade Ⅲ and its relationship with high-risk human papillomavirus infection

doi:10.3877/cma.j.issn.1673-5250.2023.06.009

Objective

To explore serum sex hormone levels in patients with cervical intraepithelial neoplasia (CIN) grade Ⅲ and its relationship with high-risk human papillomavirus (HR-HPV) infection.

Methods

A total of 105 CIN grade Ⅲ patients treated at Xuzhou Central Hospital from December 2019 to February 2022 were selected as research objects and included in the observation group, as well as 107 healthy individuals who underwent physical examinations at the same hospital during the same period were included in the control group. According to human papillomavirus (HPV) detection results, the patients in observation group were divided into HR-HPV subgroup (n=70, various types of HR-HPV infection) and non-HR-HPV subgroup (n=35, no/various types of low-risk HPV infection). Serum sex hormone levels of two groups of subjects or two subgroups of patients were compared by independent sample t test. The serum sex hormone levels among patients with different types of HR-HPV single infection were overall and pairwise compared by one-way ANOVA and least significant difference (LSD)-t test, respectively. The single, double, and total infection rates of different types of HR-HPV between two groups of subjects were compared by chi-square test. The procedures followed in this study was approved by the Medical Ethics Committee of Xuzhou Central Hospital (Approval No. 201906), and all participants have informed consent to the study and signed the informed consent forms.

Results

① The serum levels of follicle stimulating hormone (FSH) and luteinizing hormone (LH) in observation group were lower than those in control group, while the serum levels of prolactin, estradiol and progesterone were higher than those in control group, and the differences were statistically significant (P<0.05). ② The single infection rates of HPV16, HPV18 and HPV52, the double infection rate of HPV16+ HPV18, and the total infection rate of HR-HPV in observation group were all higher than those in control group, and the differences were statistically significant (P<0.05). ③ The serum levels of FSH and LH in HR-HPV subgroup were (1.8±0.4) mIU/mL and (1.6±0.1) mIU/mL, respectively, which were lower than those of (2.4±0.5) mIU/mL and (1.9±0.3) mIU/mL respectively in non-HR-HPV subgroup; while the serum estradiol concentration was (302.5±32.3) pmoL/L, which was higher than that of (268.2±23.1) pmoL/L in non-HR-HPV subgroup, and the differences were statistically significant (t=7.44, 5.55, 6.54, all with P<0.001). ④ The serum estradiol levels in patients with HPV16 infection were higher than those with HPV18, HPV52 and HPV58 infection, respectively, and the differences were statistically significant (P<0.05). However, there were no significant differences in serum FSH, prolactin, LH and progesterone levels among patients with single infection of these 4 types of HR-HPV (P>0.05).

Conclusions

Abnormal serum sex hormone levels in CIN grade Ⅲ patients are associated with HR-HPV infection. Clinically, we can monitor the HR-HPV infection by detecting the serum sex hormone levels of CIN grade Ⅲ patients, so as to provide reference for formulate the prevention and treatment plan for cervical cancer.

Key words: Cervical intraepithelial neoplasia, Gonadal steroid hormones, Human papillomavirus viruses, Follicle stimulating hormone, Luteinizing hormone, Prolactin, Estradiol, Progesterone, Femininity

表1 观察组与对照组受试者血清性激素水平比较(

±s)

组别	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
观察组	105	1.9±0.5	303.2±68.4	1.7±0.5	293.6±26.4	3.3±1.2
对照组	107	4.7±1.2	204.2±51.6	6.5±2.1	176.2±25.5	1.4±0.3
t值		21.94	12.44	23.84	32.81	13.14
P值		<0.001	<0.001	<0.001	<0.001	<0.001

表1 观察组与对照组受试者血清性激素水平比较(

±s)

组别	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
观察组	105	1.9±0.5	303.2±68.4	1.7±0.5	293.6±26.4	3.3±1.2
对照组	107	4.7±1.2	204.2±51.6	6.5±2.1	176.2±25.5	1.4±0.3
t值		21.94	12.44	23.84	32.81	13.14
P值		<0.001	<0.001	<0.001	<0.001	<0.001

表2 观察组和对照组受试者HR-HPV不同亚型单一、双重及总感染率比较[例数(%)]

组别	例数	单一感染				双重感染		总感染率
组别	例数	HPV16	HPV18	HPV52	HPV58	HPV16＋HPV18	HPV16＋HPV52	总感染率
观察组	105	28(26.7)	20(19.1)	11(10.5)	1(1.0)	6(5.7)	4(3.8)	70(66.7)
对照组	107	4(3.7)	2(1.9)	1(0.9)	0(0)	0(0)	0(0)	7(6.5)
χ²值		—	—	—	—	—	—	92.38
P值		<0.001	<0.001	0.011	0.971	0.048	0.149	<0.001

表2 观察组和对照组受试者HR-HPV不同亚型单一、双重及总感染率比较[例数(%)]

组别	例数	单一感染				双重感染		总感染率
组别	例数	HPV16	HPV18	HPV52	HPV58	HPV16＋HPV18	HPV16＋HPV52	总感染率
观察组	105	28(26.7)	20(19.1)	11(10.5)	1(1.0)	6(5.7)	4(3.8)	70(66.7)
对照组	107	4(3.7)	2(1.9)	1(0.9)	0(0)	0(0)	0(0)	7(6.5)
χ²值		—	—	—	—	—	—	92.38
P值		<0.001	<0.001	0.011	0.971	0.048	0.149	<0.001

表3 HR-HPV亚组和非HR-HPV亚组CIN Ⅲ患者血清性激素水平比较(

±s)

组别	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
HR-HPV亚组	70	1.8±0.4	323.3±64.5	1.6±0.1	302.5±32.3	3.2±0.2
非HR-HPV亚组	35	2.4±0.5	293.9±52.5	1.9±0.3	268.2±23.1	3.0±0.4
t值		7.44	1.03	5.55	6.54	1.44
P值		<0.001	0.312	<0.001	<0.001	0.125

表3 HR-HPV亚组和非HR-HPV亚组CIN Ⅲ患者血清性激素水平比较(

±s)

组别	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
HR-HPV亚组	70	1.8±0.4	323.3±64.5	1.6±0.1	302.5±32.3	3.2±0.2
非HR-HPV亚组	35	2.4±0.5	293.9±52.5	1.9±0.3	268.2±23.1	3.0±0.4
t值		7.44	1.03	5.55	6.54	1.44
P值		<0.001	0.312	<0.001	<0.001	0.125

表4 不同亚型HR-HPV单一感染CIN Ⅲ患者血清性激素水平比较(

±s)

HR-HPV亚型	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
HPV16	28	1.9±0.4	381.7±79.4	1.7±0.5	365.1±31.6	4.3±1.5
HPV18	20	2.0±0.6	374.7±85.7	2.0±0.5	341.6±25.3	4.8±1.4
HPV52	11	2.2±0.7	352.4±77.5	2.1±0.6	358.2±30.5	4.1±0.8
HPV58	1	2.8±0	343.3±0	2.3±0	334.3±0	4.2±0
F值		1.42	0.68	2.21	2.81	1.49
P值		0.246	0.775	0.068	0.023	0.437

表4 不同亚型HR-HPV单一感染CIN Ⅲ患者血清性激素水平比较(

±s)

HR-HPV亚型	例数	FSH(mIU/mL)	催乳素(mIU/L)	LH(mIU/mL)	雌二醇(pmoL/L)	孕酮(nmoL/L)
HPV16	28	1.9±0.4	381.7±79.4	1.7±0.5	365.1±31.6	4.3±1.5
HPV18	20	2.0±0.6	374.7±85.7	2.0±0.5	341.6±25.3	4.8±1.4
HPV52	11	2.2±0.7	352.4±77.5	2.1±0.6	358.2±30.5	4.1±0.8
HPV58	1	2.8±0	343.3±0	2.3±0	334.3±0	4.2±0
F值		1.42	0.68	2.21	2.81	1.49
P值		0.246	0.775	0.068	0.023	0.437

[9]	Bartels HC, Postle J, Rogers AC, et al. Prophylactic human papillomavirus vaccination to prevent recurrence of cervical intraepithelial neoplasia: a Meta-analysis[J]. Int J Gynecol Cancer, 2020, 30(6): 777-782. DOI: 10.1136/ijgc-2020-001197.
[10]	Nasioudis D, Albright BB, Haggerty AF, et al. Survival following minimally invasive radical hysterectomy for patients with cervical carcinoma and tumor size ≤2 cm[J]. Am J Obstet Gynecol, 2021, 224(3): 317-318.e2. DOI: 10.1016/j.ajog.2020.10.044.
[11]	Ciaffi J, van Leeuwen NM, Schoones JW, et al. Sex hormones and sex hormone-targeting therapies in systemic sclerosis: a systematic literature review[J]. Semin Arthritis Rheum, 2020, 50(1): 140-148. DOI: 10.1016/j.semarthrit.2019.07.007.
[12]	王宪伟，袁风菊，徐培，等. 高级别鳞状上皮内病变病人子宫颈切除术后人乳头瘤病毒持续感染的相关危险因素研究[J]. 安徽医药，2023, 27(12): 2412-2416. DOI: 10.3969/j.issn.1009-6469.2023.12.017.
[13]	Zhai Q, Zhang W, Zhang Z, et al. Characteristics of the cervicovaginal microenvironment in childbearing-age women with different degrees of cervical lesions and HR-HPV positivity[J]. Pol J Microbiol, 2021, 70(4): 489-500. DOI: 10.33073/pjm-2021-046.
[14]	DE Oliveira Neto CP, Brito HO, DA Costa RMG, et al. Is there a role for sex hormone receptors in head-and-neck cancer? Links with HPV infection and prognosis[J]. Anticancer Res, 2021, 41(8): 3707-3716. DOI: 10.21873/anticanres.15162.
[15]	何学森，涂常清，钟晓，等. 深圳市龙岗社区HPV筛查及感染的相关危险因素探析[J]. 中国妇幼健康研究，2020, 31(5): 573-579. DOI: 10.3969/j.issn.1673-5293.2020.05.005.
[16]	李贺同，任晶晶，王文豪，等. 雌激素及其受体协同HPV在宫颈癌肿瘤微环境中作用的研究进展[J]. 基础医学与临床，2022, 42(9): 1438-1442. DOI: 10.16352/j.issn.1001-6325.2022.09.1438.
[17]	马闻擎，李欣然，谢嘉欣，等. 免疫性早发性卵巢功能不全患者血清miR-21及外周血单核细胞Peli1的表达及意义[J]. 解放军医学杂志，2021, 46(3): 252-257. DOI: 10.11855/j.issn.0577-7402.2021.03.06.
[18]	孔艳，刘敬，程凤凤，等. Fas p53 HPV E2 HPV E6及HPV E7蛋白在不同宫颈病变组织中的表达及意义[J]. 中国妇幼保健，2021, 36(19): 4564-4567. DOI: 10.19829/j.zgfybj.issn.1001-4411.2021.19.053.
[1]	白菊萍，徐星榕，边芸. P16, P53及Ki67在子宫颈鳞状细胞癌(SCC)，宫颈上皮内瘤变(CIN)及慢性炎症中表达水平及临床意义[J]. 中国妇产科临床杂志，2022, 23(5): 474-476. DOI: 10.13390/j.issn.1672-1861.2022.05.009.
[2]	谭先杰. 郎景和院士谈子宫颈癌的防治策略[J]. 中国实用妇科与产科杂志，2021, 37(1): 1-6. DOI: 10.19538/j.fk2021010101.
[3]	Chen JY, Wang ZL, Wang ZY, et al. The risk factors of residual lesions and recurrence of the high-grade cervical intraepithelial lesions (HSIL) patients with positive-margin after conization[J]. Medicine, 2018, 97(41): e12792. DOI: 10.1097/MD.0000000000012792.
[4]	杨玉丽，胡欣，杨萍，等. 基于Tobit模型的宫颈上皮内瘤变患者健康效用值影响因素研究[J]. 中国预防医学杂志，2022, 23(10): 760-766. DOI: 10.16506/j.1009-6639.2022.10.007.
[5]	Zhang J, Cheng K, Wang Z. Prevalence and distribution of human papillomavirus genotypes in cervical intraepithelial neoplasia in China: a Meta-analysis[J]. Arch Gynecol Obstet, 2020, 302(6): 1329-1337. DOI: 10.1007/s00404-020-05787-w.
[6]	Son J, Park Y, Chung SH. Epithelial oestrogen receptor α is dispensable for the development of oestrogen-induced cervical neoplastic diseases[J]. J Pathol, 2018, 245(2): 147-152. DOI: 10.1002/path.5069.
[7]	林俊. 阴道镜下活检对不同级别宫颈上皮内瘤变的诊断价值及影响因素分析[J]. 中国妇幼保健，2023, 38(22): 4423-4427. DOI: 10.19829/j.zgfybj.issn.1001-4411.2023.22.032.
[8]	Falcaro M, Castañon A, Ndlela B, et al. The effects of the national HPV vaccination programme in England, UK, on cervical cancer and grade 3 cervical intraepithelial neoplasia incidence: a register-based observational study[J]. Lancet, 2021, 398(10316): 2084-2092. DOI: 10.1016/S0140-6736(21)02178-4.

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[7]	Yuan Wei, Hong Luo. Predictive value of uterine artery blood flow parameters and serological indexes in pregnant women with early threatened abortion[J]. Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition), 2022, 18(01): 111-119.
[8]	Xiaofei Sun, Yiqun Gu, Aichun Wang, Li Wang, Fanfan Meng, Jun Wang, lijuan Lu. Evaluation on cervical intraepithelial neoplasia for patients with cervicitis by p16/Ki-67 double staining[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2022, 16(06): 418-425.
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[15]	Yusheng Hu, Haihui Liu, Yuguo Qiu. Correlation analysis of physical development indexes and salivary sex hormones in obese children[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(01): 36-40.

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