Liu Bo, Wei Ling, Wu Lirui, Wang Huiying, Wang Hongli, Yu Qian
Department of Gynecology, Hebei Petro China Center Hospital, Langfang, People's Republic of China.
Int J Womens Health. 2025 Jan 7;17:43-51. doi: 10.2147/IJWH.S492376. eCollection 2025.
To analyze the relationship and predictive value of Netrin-1 expression and ultrasonic blood flow parameters with the severity of cervical intraepithelial neoplasia (CIN).
A retrospective analysis was performed on 115 patients diagnosed with CIN and 37 patients with chronic cervicitis, all of whom underwent surgical intervention. The expression levels of Netrin-1 were evaluated through immunohistochemical staining and quantitative fluorescence PCR. Doppler ultrasound was employed to quantify flow index (FI), vascularization index (VI), and vascularization flow index (VFI) using VOCAL software. Statistical analyses, including correlation analysis, logistic regression, and receiver operating characteristic (ROC) curve analysis, were conducted to assess the predictive value of Netrin-1 expression and ultrasound-derived blood flow parameters.
FI, VI, and VFI increased with CIN grade, showing significant differences between CIN II, CIN III, and the control group (P < 0.05). Netrin-1 levels were negatively correlated with FI, VI, and VFI (correlation coefficients of -0.287, -0.309, and -0.298; P < 0.05). Logistic regression indicated that Netrin-1 positivity was a protective factor against CIN III, while FI, VI, and VFI were risk factors. The AUC for Netrin-1 was 0.712, with sensitivity and specificity of 76.4% and 79.5% (P < 0.05).
Netrin-1 expression is significantly reduced in CIN patients, whereas Doppler ultrasound-derived blood flow parameters-FI, VI, and VFI-are markedly elevated. Both Netrin-1 levels and these ultrasound parameters exhibit a strong correlation with the severity of cervical lesions. Notably, Netrin-1 is negatively correlated with FI, VI, and VFI. Furthermore, Netrin-1 positivity serves as a protective factor against CIN III lesions, while elevated levels of FI, VI, and VFI are associated with increased risk for these lesions. The expression levels of both Netrin-1 and ultrasound parameters provide valuable predictive insights for the early screening, diagnosis, and prevention of cervical cancer.
分析Netrin-1表达及超声血流参数与宫颈上皮内瘤变（CIN）严重程度的关系及预测价值。
对115例诊断为CIN的患者和37例慢性宫颈炎患者进行回顾性分析，所有患者均接受了手术干预。通过免疫组织化学染色和定量荧光PCR评估Netrin-1的表达水平。采用多普勒超声，使用VOCAL软件定量血流指数（FI）、血管化指数（VI）和血管化血流指数（VFI）。进行包括相关性分析、逻辑回归和受试者工作特征（ROC）曲线分析在内的统计分析，以评估Netrin-1表达和超声衍生血流参数的预测价值。
FI、VI和VFI随CIN分级增加，在CIN II、CIN III与对照组之间存在显著差异（P < 0.05）。Netrin-1水平与FI、VI和VFI呈负相关（相关系数分别为-0.287、-0.309和-0.298；P < 0.05）。逻辑回归表明，Netrin-1阳性是CIN III的保护因素，而FI、VI和VFI是危险因素。Netrin-1的曲线下面积（AUC）为0.712，敏感性和特异性分别为76.4%和79.5%（P < 0.05）。
CIN患者中Netrin-1表达显著降低，而多普勒超声衍生的血流参数——FI、VI和VFI——明显升高。Netrin-1水平和这些超声参数均与宫颈病变严重程度密切相关。值得注意的是，Netrin-1与FI、VI和VFI呈负相关。此外，Netrin-1阳性是CIN III病变的保护因素，而FI、VI和VFI水平升高与这些病变风险增加相关。Netrin-1和超声参数的表达水平为宫颈癌的早期筛查、诊断和预防提供了有价值的预测见解。
