Expression of cyclin-dependent kinase inhibitor 2A and B lymphocyte-induced mature protein 1 in cervical high-grade squamous intraepithelial lesions and its correlation with disease progression

Yu Chunxiang; Yan Meihong; Li Yan; Du Yifei

doi:10.3760/j.issn.1673-4777.2025.09.017

Abstract：Objective To investigate the expression of cyclin-dependent kinase inhibitor 2 A(CDKN2A)and B lymphocyte-induced mature protein 1(Blimp-1)in cervical high-grade squamous intraepithelial lesion(HSIL)and their relationship with the progression of HSIL.Methods A total of 815 patients with HSIL who underwent cervical conization in Shanxi Children's Hospital from January 2019 to January 2022 were selected.According to the postoperative pathological results,the patients were divided into progressive group and non-progressive group.The surgically resected cervical tissues were taken to detect the expression of CDKN2A mRNA and Blimp-1 mRNA.Pearson method was used to analyze the correlation between CDKN2A mRNA and Blimp-1 mRNA.Multivariate Logistic regression was used to analyze the risk factors for the progression of HSIL.Receiver operating characteristic curve was used to analyze the value of CDKN2A mRNA and Blimp-1 mRNA in the diagnosis of HSIL progression.Results Among 815 patients with HSIL,97 cases(11.9％)were confirmed to progress to cervical cancer by postoperative pathology,which was the progressive group,and the remaining 718 cases(88.1％)were the non-progressive group.The expression level of CDKN2A mRNA in cervical tissue of progressive group was lower than that of non-progressive group[(0.53±0.13)vs(1.43±0.27)],and the expression level of Blimp-1 mRNA was higher than that of non-progressive group[(2.65±0.71)vs(1.27±0.24)](all P＜0.001).The expression of CDKN2A mRNA was negatively correlated with the expression of Blimp-1 mRNA in cervical tissues(r=-0.650,P＜0.05).Human papillomavirus 16/18 infection,cervical intraepithelial neoplasia grade 3 and high expression of Blimp-1 mRNA were risk factors for HSIL progression to cervical cancer(all P＜0.05),and high expression of CDKN2A mRNA was a protective factor(P＜0.05).The area under the curve of CDKN2A mRNA and Blimp-1 mRNA in the diagnosis of HSIL progression was 0.777 and 0.759,respectively.The area under the curve of combined diagnosis was 0.920,which was higher than that of single diagnosis(both P＜0.05).Conclusion Low expression of CDKN2A mRNA and high expression of Blimp-1 mRNA in cervical tissues are risk factors for the progression of HSIL to cervical cancer.The combination of CDKN2A mRNA and Blimp-1 mRNA can predict the risk of HSIL progression.