Relationship between human papilloma virus-DNA and cytomegalovirus-DNA virus content and risk factors of endometrial cancer and prediction model / 中国医师进修杂志

ABSTRACT

Objective:To explore the relationship between human papilloma virus (HPV)-DNA and cytomegalovirus (CMV)-DNA virus content and the risk factors of endometrial cancer (EC) and their prediction models.Methods:Fifty-eight patients with EC from January 2017 to June 2020 in Suzhou Hospital Affiliated to Anhui Medical University were selected as the observation group, and 58 patients with endometrial hyperplasia (EH) during the same period were selected as the control group according to the 1∶1 matching case control principle. The clinical data, HPV-DNA, CMV-DNA positive rate and virus content of the two groups were compared, and the independent variables with P<0.05 were included in the Logistic regression model through single factor analysis. The risk factors of EC were analyzed, and the correlation between HPV-DNA, CMV-DNA and EC risk factors were evaluated. Logistic regression model was evaluated using the likelihood ratio chi-square and goodness-of-fit test, and the receiver operating characteristic (ROC) curve was used to analyze the predictive value of the model to EC. Results:The proportion of patients with age ≥ 55 years old, body mass index (BMI)≥ 24 kg/m 2, a history of hypertension and diabetes, malignant tumor family history and hormone replacement therapy history in the observation group were higher than those in the control group 72.41%(42/58) vs. 39.66%(23/58),70.69% (41/58) vs. 43.10%(25/58), 36.21%(21/58) vs. 10.34%(6/58), 31.03%(18/58) vs. 8.62%(5/58),29.31%(17/58) vs. 5.17%(3/58), 27.93%(17/58) vs. 8.62%(5/58), and the differences were statistically significant ( P<0.05). The positive rates of HPV and CMV, the contents of HPV-DNA and CMV-DNA in the observation group were higher than those in the control group 62.07%(36/58) vs. 29.31%(17/58),81.03%(47/58) vs. 41.38%(24/58), (471.16 ± 33.58) copies/ml vs. (240.08 ± 17.41) copies/ml, (256.19 ± 24.77) copies/ml vs. (132.27 ± 13.20) copies/ml, the differences were statistically significant ( P<0.05). Age ≥ 55 years, BMI ≥ 24 kg/m 2, history of hypertension and diabetes, family history of malignant tumors, history of hormone replacement therapy, HPV positive, CMV positive were risk factors for EC ( P<0.05). HPV-DNA virus content was positively correlated with the age of EC patients, family history of malignant tumors, and history of diabetes ( P<0.05), the viral content of CMV-DNA was positively correlated with age, family history of malignant tumors, and history of hypertension ( P<0.05). According to the ROC curve drawn by the predicted value and the true value of the Logistic regression model, the area under the curve was 0.930 (95% CI 0.885 - 0.976), when the predictive probability of individual nosocomial infection>0.528, the prediction sensitivity was 84.48%, and the specificity was 89.66%. Conclusions:The occurrence of EC is related to many factors, and the content of HPV-DNA and CMV-DNA viruses are the risk factors of its occurrence. The overall predictive value of a Logistic regression model constructed based on EC pathological characteristics and the virus content of HPV-DNA and CMV-DNA is high, and it has clinical application prospects.