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| Value of the vaginal microecological imbalance combined with the serum human leukocyte antigen-G and human leukocyte antigen levels of patients with cervical high-grade squamous intraepithelial lesion after cold knife conization for evaluating their persistent human papillomavirus infection |
| Beijing Chuiyangliu Hospital, Beijing, 100022 |
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Abstract To explore the predictive value of the vaginal microecological imbalance combined with the serum human leukocyte antigen-G (HLA-G) and human leukocyte antigen (HLA-E) levels of patients with cervical high-grade squamous intraepithelial lesion (HSIL) after cold knife conization (CKC) for their persistent human papillomavirus (HPV) infection. Methods: The clinical data of 137 patients with HSIL admitted to the hospital from January 2021 to December 2022 were collected retrospectively. These patients were treated with CKC and were followed up for 1 year after CKC. The HPV persistent infection of these patients after CKC was observed. The vaginal microecology and the serum HLA-G and HLA-E levels of the patients were measured. The correlation between the vaginal microecology and the serum HLA-G and HLA-E levels of the patients and their cervix HPV persistent infection was analyzed. The value of the vaginal microecology and the serum HLA-G and HLA-E levels of the patients for predicting their HPV persistent infection were evaluated. Results: There were 31 patients with the persistent HPV infection (in group A) and 106 cases without the persistent HPV infection (in group B) in 137 patients. There were significant
differences in the vaginal pH value, the density and diversity of the vaginal flora and the rate of trichomonas vaginitis of the patients between the two groups. The vaginal microecological imbalance rate of the patients in group A was significantly higher than that of the patients in group B. The levels of the serum HLAG (19.84±3.53 ng/ml) and HLA-E (75.39±15.83 pg/ml) of the patients in group A were significantly higher than those (16.93±2.96 ng/ml and 68.42±12.51 pg/ml) of the patients in group B. In group A, the levels of serum HLA-G and HLA-E of the patients with vaginal microecological imbalance were significantly higher than those of the patients with normal vaginal microecology (all P<0.05). Spearman correlation analysis showed that the vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients were positively correlated with their postoperative persistent HPV infection (r=0.633, 0.529, 0.608, all P<0.05). Receiver operating characteristic curve analysis showed that the area under the curve of the vaginal microecological imbalance, the serum HLA-G level, the HLA-E level, and the combined vaginal microecological imbalance and the serum HLA-G and HLA-E levels of the patients for evaluating their postoperative persistent HPV infection were 0.601, 0.773, 0.805 and 0.885, respectively (P<0.05). Conclusion: The vaginal microecological imbalance combined with the serum HLA-G and HLA-E levels of the patients with HSIL after CKC has certain predictive value for their postoperative HPV persistent infection.
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