外周血Th17/Treg细胞联合超声弹性成像对宫颈病变的临床诊断价值

摘要

目的 探讨外周血辅助性T17(Th17)细胞/调节性T(Treg)细胞联合超声弹性成像(UE)对宫颈病变的临床诊断价值.方法 回顾性分析大连医科大学附属第二医院2017年10月至2018年10月收治的60例宫颈癌(CC)患者、55例宫颈上皮内瘤变(CIN)患者,57例宫颈无病变的健康体检者的临床资料,依次将其纳入CC组、CIN组、对照组,检测三组外周血中Th17细胞、Treg细胞水平,并行超声弹性成像检查,分析Th17/Treg细胞、超声弹性成像及两者联合诊断宫颈病变的准确性.结果 CC组外周血中Th17细胞、Treg细胞水平及Th17/Treg明显高于CIN组及对照组,差异有统计学意义(P ＜0.05);CIN组外周血中Th17细胞、Treg细胞水平及Th17/Treg明显高于对照组,差异有统计学意义(P ＜0.05);CC组超声弹性成像评分明显高于CIN组及对照组,差异有统计学意义(P ＜0.05);CIN组超声弹性成像评分略高于对照组,无统计学差异(P＞ 0.05);超声弹性成像诊断宫颈病变的准确性显著高于Th17/Treg细胞,差异有统计学意义(P ＜0.05);Th17/Treg细胞联合超声弹性成像诊断宫颈病变的准确性显著高于Th17/Treg细胞、超声弹性成像,差异有统计学意义(P ＜0.05).结论 外周血Th17/Treg细胞联合超声弹性成像能有效提高宫颈癌前病变及宫颈癌检出率,有一定临床诊断价值.%Objective To investigate clinical diagnostic value of peripheral blood T helper cell 17/regulatory T cell (Th17/Treg) cells combined with ultrasound elastography (UE) for cervical lesions. Methods The clinical data of 60 cases of cervical carcinoma (CC group), 55 cases of cervical intraepithelial neoplasia (CIN group) and 57 cases of health examinees (control group) in our hospital from October 2017 to October 2018 were retrospectively analyzed. The levels of Th17 cells and Treg cells in peripheral blood of three groups were detected. All patients underwent UE examinations. Then the accuracy of Th17/Treg cells, UE and the combined detection in the diagnosis of cervical lesions were analyzed. Results The levels of Th17 cells, Treg cells and Th17/Treg in peripheral blood ranking in a descending order was CC group, CIN group and control group, with statistic difference (P ＜ 0. 05). The score of UE ranking in a descending order was CC group, CIN group and control group, with statistic difference between the CC group and CIN group & control group (P ＜ 0. 05), while no difference was found between the CIN group and control group (P＞ 0. 05). The accuracy in the diagnosis of cervical lesions ranking in an ascending order was UE, Th17/Treg cells and the combined detection, with statistic difference (P ＜ 0. 05). Conclusion The combined detection of Th17/Treg cells and UE can improve the diagnosis rate of cervical precancerous lesions and cervical cancer, which has certain clinical diagnostic value.