The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix
Abstract Background Cervical cancer is a common cancer among women worldwide and is closely related to high-risk human papillomavirus infection (HR-HPV). The immune microenvironment is thought to play an essential role in viral infection and cancer development; however, this relationship remains con...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2019-06-01
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| Series: | Infectious Agents and Cancer |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s13027-019-0231-z |
| _version_ | 1818284461132873728 |
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| author | Bohan Li Ling Zhang Jianguo Zhao Guichun Tan Wenwen Zhang Na Zhang Jing Tian Pengpeng Qu |
| author_facet | Bohan Li Ling Zhang Jianguo Zhao Guichun Tan Wenwen Zhang Na Zhang Jing Tian Pengpeng Qu |
| author_sort | Bohan Li |
| collection | DOAJ |
| description | Abstract Background Cervical cancer is a common cancer among women worldwide and is closely related to high-risk human papillomavirus infection (HR-HPV). The immune microenvironment is thought to play an essential role in viral infection and cancer development; however, this relationship remains controversial. Cytokines are an important part of the immune system. Therefore, in this study, we explored changes in cervical cytokine levels of women with persistent HR-HPV infection and determined the value of cytokine detection in assessing cervical lesions. Methods We enrolled 146 patients; 117 had long-term high-risk (HR) HPV infection (> 6 months), and 29 were HPV-negative with previous HR-HPV infection. According to histopathological examination, 43 patients were diagnosed with cervicitis; 35, with low-grade squamous intraepithelial lesions (LSILs); and 39, with high-grade squamous intraepithelial lesions (HSILs). Cytokine levels in vaginal fluid were examined using cytometric bead array, and the values of interleukin (IL)-6 and IL-2 levels were converted to a cytokine score. The performance of the cytokine score for diagnosis and risk assessment was compared with that of ThinPrep cytology tests (TCTs). Results Disease severity was positively associated with IL-6 levels and inversely related to IL-2 levels. The area under the curve (AUC) was higher for the cytokine score including IL-6 and IL-2 than for TCTs for HSILs. Comparisons of the sensitivity, specificity, Youden index, and positive and negative predictive values for HSILs demonstrated that the cytokine score was better than TCT. HPV-positive patients with high cytokine scores showed increased risk of developing HSIL within 3 years. The hazard ratio for the cytokine score was 3.12; thus, the risk of developing HSIL was related to the cytokine score. Conclusions The cytokine score increased with the severity of cervical lesions and could distinguish more patients from HPV-positive women and predict the risk of disease progression. |
| first_indexed | 2024-12-13T00:53:10Z |
| format | Article |
| id | doaj.art-fa26b05d31054684b7b96f62f4496138 |
| institution | Directory Open Access Journal |
| issn | 1750-9378 |
| language | English |
| last_indexed | 2024-12-13T00:53:10Z |
| publishDate | 2019-06-01 |
| publisher | BMC |
| record_format | Article |
| series | Infectious Agents and Cancer |
| spelling | doaj.art-fa26b05d31054684b7b96f62f44961382022-12-22T00:04:52ZengBMCInfectious Agents and Cancer1750-93782019-06-0114111210.1186/s13027-019-0231-zThe value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervixBohan Li0Ling Zhang1Jianguo Zhao2Guichun Tan3Wenwen Zhang4Na Zhang5Jing Tian6Pengpeng Qu7Tianjin Central Hospital of Gynecology and ObstetricsCang Zhou Central HospitalTianjin Central Hospital of Gynecology and ObstetricsTianjin Medical UniversityTianjin Central Hospital of Gynecology and ObstetricsTianjin Central Hospital of Gynecology and ObstetricsTianjin Central Hospital of Gynecology and ObstetricsTianjin Central Hospital of Gynecology and ObstetricsAbstract Background Cervical cancer is a common cancer among women worldwide and is closely related to high-risk human papillomavirus infection (HR-HPV). The immune microenvironment is thought to play an essential role in viral infection and cancer development; however, this relationship remains controversial. Cytokines are an important part of the immune system. Therefore, in this study, we explored changes in cervical cytokine levels of women with persistent HR-HPV infection and determined the value of cytokine detection in assessing cervical lesions. Methods We enrolled 146 patients; 117 had long-term high-risk (HR) HPV infection (> 6 months), and 29 were HPV-negative with previous HR-HPV infection. According to histopathological examination, 43 patients were diagnosed with cervicitis; 35, with low-grade squamous intraepithelial lesions (LSILs); and 39, with high-grade squamous intraepithelial lesions (HSILs). Cytokine levels in vaginal fluid were examined using cytometric bead array, and the values of interleukin (IL)-6 and IL-2 levels were converted to a cytokine score. The performance of the cytokine score for diagnosis and risk assessment was compared with that of ThinPrep cytology tests (TCTs). Results Disease severity was positively associated with IL-6 levels and inversely related to IL-2 levels. The area under the curve (AUC) was higher for the cytokine score including IL-6 and IL-2 than for TCTs for HSILs. Comparisons of the sensitivity, specificity, Youden index, and positive and negative predictive values for HSILs demonstrated that the cytokine score was better than TCT. HPV-positive patients with high cytokine scores showed increased risk of developing HSIL within 3 years. The hazard ratio for the cytokine score was 3.12; thus, the risk of developing HSIL was related to the cytokine score. Conclusions The cytokine score increased with the severity of cervical lesions and could distinguish more patients from HPV-positive women and predict the risk of disease progression.http://link.springer.com/article/10.1186/s13027-019-0231-zCytokinesFlow cytometryCervical lesionsTriageHigh-grade squamous intraepithelial lesion |
| spellingShingle | Bohan Li Ling Zhang Jianguo Zhao Guichun Tan Wenwen Zhang Na Zhang Jing Tian Pengpeng Qu The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix Infectious Agents and Cancer Cytokines Flow cytometry Cervical lesions Triage High-grade squamous intraepithelial lesion |
| title | The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix |
| title_full | The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix |
| title_fullStr | The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix |
| title_full_unstemmed | The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix |
| title_short | The value of cytokine levels in triage and risk prediction for women with persistent high-risk human papilloma virus infection of the cervix |
| title_sort | value of cytokine levels in triage and risk prediction for women with persistent high risk human papilloma virus infection of the cervix |
| topic | Cytokines Flow cytometry Cervical lesions Triage High-grade squamous intraepithelial lesion |
| url | http://link.springer.com/article/10.1186/s13027-019-0231-z |
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