Romanishin Alexander, Efimenko Bogdan, Katserov Dmitriy, Agapov Mikhail, Kakotkin Viktor, Rubina Ksenia, Zadorkina Tatiana, Semina Ekaterina
Institute of Medicine and Life Sciences, Immanuel Kant Baltic Federal University, Kaliningrad, Russia.
Moscow State University, Moscow, Russia.
Int J Gynaecol Obstet. 2025 Aug;170(2):916-926. doi: 10.1002/ijgo.70090. Epub 2025 May 5.
To explore the relationships between HPV genotypes, vaginal microbiota, oncogenic mutations, and cervical intraepithelial neoplasia (CIN) to develop a risk assessment model for predicting CIN.
A cross-sectional analysis was conducted on 264 women living in the Kaliningrad region, assessing CIN presence, HPV genotypes, vaginal microbiota composition, and mutations in key oncogenes.
HPV genotypes 16, 31, 33, 35, 58, and 66 were identified as the most prevalent among patients with HPV infections. However, in a multifactorial model, only HPV genotypes 16 and 58 demonstrated a significant association with high-grade squamous intraepithelial lesions and above. Genetic analysis revealed mutations in TP53 and ERBB2 genes in 20 and 17 patients, respectively, with TP53 mutations showing a notable correlation with CIN progression. Two patients with diagnoses of "Negative for Intraepithelial Lesion or Malignancy" carried the TP53 R248W mutation, a well-established neoplasia-related variant, highlighting its potential as a predictor of precancerous conditions. Increased copy numbers of human DNA and Enterobacteriaceae DNA correlated with low-grade squamous intraepithelial lesions, though many DNA-derived features displayed instability in logistic regression models, suggesting the need for further validation.
These findings suggest that although HPV genotypes, genetic mutations, and microbiota profiles may serve as markers for CIN, their predictive reliability requires further investigation. The present study represents the first large-scale exploration of these factors conducted within the Russian female population.
探讨人乳头瘤病毒(HPV)基因型、阴道微生物群、致癌突变与宫颈上皮内瘤变(CIN)之间的关系,以建立预测CIN的风险评估模型。
对居住在加里宁格勒地区的264名女性进行横断面分析,评估CIN的存在情况、HPV基因型、阴道微生物群组成以及关键致癌基因的突变情况。
HPV基因型16、31、33、35、58和66被确定为HPV感染患者中最常见的基因型。然而,在多因素模型中,只有HPV基因型16和58与高级别鳞状上皮内病变及以上病变存在显著关联。基因分析显示,分别有20例和17例患者的TP53和ERBB2基因发生突变,TP53突变与CIN进展显著相关。两名诊断为“上皮内病变或恶性肿瘤阴性”的患者携带TP53 R248W突变,这是一种公认的肿瘤相关变体,突出了其作为癌前病变预测指标的潜力。人DNA和肠杆菌科DNA拷贝数增加与低级别鳞状上皮内病变相关,尽管许多DNA衍生特征在逻辑回归模型中显示出不稳定性,这表明需要进一步验证。
这些发现表明,尽管HPV基因型、基因突变和微生物群谱可能作为CIN的标志物,但其预测可靠性需要进一步研究。本研究是在俄罗斯女性人群中对这些因素进行的首次大规模探索。