Ssedyabane Frank, Niyonzima Nixon, Ngonzi Joseph, Nambi Najjuma Josephine, Mudondo Hope, Okeny Christopher, Nuwashaba Doreen, Tusubira Deusdedit
Department of Medical Laboratory Science, Faculty of Medicine, Mbarara University of Science of Science and Technology, P.O. Box 1410, Mbarara, Uganda.
Research and Training Directorate, Uganda Cancer Institute, P. O. Box 3935, Kampala, Uganda.
Gynecol Oncol Rep. 2024 Jul 24;55:101466. doi: 10.1016/j.gore.2024.101466. eCollection 2024 Oct.
Biomarkers including Forkhead/winged-helix transcription factor box P3 have been proposed in immunohistochemical techniques to diagnose cervical lesions, but can be objectively quantified and measured in blood using methods that can be standardised. In this study we quantified the serum FOXP3 concentrations and assessed their association with cervical lesions at the cervical cancer clinic of Mbarara Regional Hospital (MRRH) Southwestern Uganda. We performed secondary analysis on archived serum samples from a previous unmatched case control study in which we recruited 90 cervical cancer (CC) cases, 90 cervical intraepithelial neoplasia (CIN) cases before any form of treatment and 90 controls. Clinical and demographic data were recorded. We measured FOXP3 concentrations using quantitative ELISA. We performed descriptive statistics and logistic regression in STATA 17 and took P-values of < 0.05 as statistically significant. The mean concentration of FOXP3 was higher in serum samples from CC cases compared with CIN cases and controls, and this difference was statistically significant (P value < 0.001). More than half (52/90,58 %) of serum samples from CC cases had FOXP3 concentrations greater than 0.0545 ng/ml (P value < 0.001). Increase serum FOXP3 expression was not associated with CIN. Increase in serum FOXP3 concentrations were observed to increase the chances of CC by 2 times (OR: 2.094, P value 0.038, 95 % CI: 1.042---4.209). Serum FOXP3 is likely associated with cervical lesions especially CC in our study population. Serum FOXP3 testing may be useful in resource limited settings to aid detection of such lesions given the challenges associated with cytology and VIA. We recommend diagnostic utility studies for circulating FOXP3 as a biomarker for detection of cervical cancer.
包括叉头/翼状螺旋转录因子盒P3在内的生物标志物已被用于免疫组织化学技术诊断宫颈病变，但可以使用能够标准化的方法在血液中进行客观定量和测量。在本研究中，我们在乌干达西南部姆巴拉拉地区医院（MRRH）的宫颈癌诊所对血清FOXP3浓度进行了定量，并评估了其与宫颈病变的关联。我们对之前一项非匹配病例对照研究中存档的血清样本进行了二次分析，在该研究中，我们招募了90例宫颈癌（CC）病例、90例未经任何形式治疗的宫颈上皮内瘤变（CIN）病例和90例对照。记录了临床和人口统计学数据。我们使用定量酶联免疫吸附测定法（ELISA）测量FOXP3浓度。我们在STATA 17中进行了描述性统计和逻辑回归分析，并将P值<0.05视为具有统计学意义。与CIN病例和对照相比，CC病例血清样本中FOXP3的平均浓度更高，且这种差异具有统计学意义（P值<0.001）。超过一半（52/90，58%）的CC病例血清样本中FOXP3浓度大于0.0545 ng/ml（P值<0.001）。血清FOXP3表达增加与CIN无关。观察到血清FOXP3浓度增加使患CC的几率增加2倍（比值比：2.094，P值0.038，95%置信区间：1.042---4.209）。在我们的研究人群中，血清FOXP3可能与宫颈病变尤其是CC有关。鉴于细胞学检查和醋酸肉眼观察法（VIA）存在的挑战，血清FOXP3检测在资源有限的环境中可能有助于此类病变的检测。我们建议开展关于循环FOXP3作为宫颈癌检测生物标志物的诊断效用研究。
