Objective: The current study aimed to delineate the relationship between furin and chronic inflammation while cervical intraepithelial neoplasia progresses to cancer. Study Design: This cross-sectional study included 81 women who required colposcopic examinations. The study groups were formed based on pathological results: Group I included women with cervical intraepithelial neoplasia (CIN) I (n = 30); Group II included women with CIN II-III (n = 28); and Group III included women with cervical cancer (CC) (n = 23). Furin, ki-67, and p16 levels were evaluated based on immunostaining intensity. The inflammatory indices were calculated in parallel with the literature from routine blood samples retrieved within one week before the procedure. Results: Furin expression gradually increased from CIN I to CIN II-III and from CIN II-III to CC, respectively (p< 0.001,p= 0.005). NLR, MLR, PLR, and SII were significantly higher in the CC group (p< 0.001). ROC curve analysis unveiled that NLR, MLR, PLR, and SII predicted the presence of CC with a cutoff value of 2.39 for NLR (sensitivity: 91.3%, specificity: 63.8%, AUROC: 0.79,p< 0.001); a cutoff value of 0.27 for MLR (sensitivity: 78.3%, specificity: 72.4%, AUROC: 0.77,p= 0.009); a cutoff value of 123 for PLR (sensitivity: 100%, specificity: 41.4%, AUROC: 0.70,p= 0.04); and a cutoff value of 747 for SII (sensitivity: 69.6%, specificity: 90.7%, AUROC: 0.71,p= 0.014). Conclusion: Furin expression increased gradually in parallel with the severity of cervical intraepithelial neoplasia. The inflammatory indices were higher in the presence of CC and denoted a good discrimination ability for predicting cervical cancer.
目的：本研究旨在阐明宫颈上皮内瘤变进展为癌症过程中，弗林蛋白酶与慢性炎症之间的关系。研究设计：本横断面研究纳入了81名需接受阴道镜检查的女性。根据病理结果将研究对象分为三组：第一组为宫颈上皮内瘤变（CIN）I级患者（n=30）；第二组为CIN II-III级患者（n=28）；第三组为宫颈癌（CC）患者（n=23）。通过免疫染色强度评估弗林蛋白酶、ki-67和p16的表达水平。炎症指标根据术前一周内采集的常规血液样本，参照文献方法进行计算。结果：弗林蛋白酶表达水平从CIN I到CIN II-III级，再从CIN II-III级到宫颈癌呈逐步升高趋势（p<0.001，p=0.005）。宫颈癌组的中性粒细胞-淋巴细胞比值（NLR）、单核细胞-淋巴细胞比值（MLR）、血小板-淋巴细胞比值（PLR）和全身免疫炎症指数（SII）均显著增高（p<0.001）。受试者工作特征曲线分析显示，NLR、MLR、PLR和SII对宫颈癌具有预测价值：NLR最佳截断值为2.39（敏感性91.3%，特异性63.8%，曲线下面积0.79，p<0.001）；MLR最佳截断值为0.27（敏感性78.3%，特异性72.4%，曲线下面积0.77，p=0.009）；PLR最佳截断值为123（敏感性100%，特异性41.4%，曲线下面积0.70，p=0.04）；SII最佳截断值为747（敏感性69.6%，特异性90.7%，曲线下面积0.71，p=0.014）。结论：弗林蛋白酶表达水平随宫颈上皮内瘤变严重程度逐步升高。炎症指标在宫颈癌患者中显著增高，对预测宫颈癌具有良好的鉴别能力。
肿瘤(癌症)患者之家