International journal of general medicine · 2026
Predictive Value of S100A8/A9 Combined with sSDC1 in Vaginal Lavage Fluid for Persistent High-Risk HPV Infection and Vaginal Dysbiosis.
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Song Weifu, Hu Yanqiong, Zhang Ning, Zhao Xin, Zhu Hongjie
Аннотация
OBJECTIVE: To investigate the association of vaginal lavage fluid levels of S100 calcium-binding protein A8/A9 complex (S100A8/A9) and soluble syndecan-1 (sSDC1) with high-risk human papillomavirus (HR-HPV) persistent infection and vaginal microecology.
METHODS: In this prospective cohort study, 403 HR-HPV--positive patients without cervical intraepithelial neoplasia grade 2 or worse were enrolled between April 2023 and February 2024. Genotypes included HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, 12 of which are Group 1 carcinogens per the International Agency for Research on Cancer (IARC). Over 2 years, 245 cleared and 158 had persistent infection. Enzyme-linked immunosorbent assay measured S100A8/A9 and sSDC1 levels. Spearman correlation assessed relationships with viral load and vaginal pH. LASSO regression screened variables, followed by multivariable logistic regression. Receiver operating characteristic (ROC) curves evaluated predictive performance.
RESULTS: In the persistent infection group, HPV16 (39.87%) and HPV18 (22.78%) predominated. S100A8/A9, sSDC1, and dysbiosis indicators were higher in the persistent group (all P<0.05). S100A8/A9 and sSDC1 correlated positively with viral load (r=0.351 and 0.364) and vaginal pH (r=0.475 and 0.422; all P<0.001). Multivariable analysis identified elevated viral load and vaginal pH, abnormal microecological indicators, and elevated S100A8/A9 (odds ratio [OR]=1.070, 95% confidence interval [CI]: 1.002-1.141) and sSDC1 (OR=1.424, 95% CI: 1.045-1.941) as independent risk factors (all P<0.05). Combined testing yielded an area under the curve (AUC) of 0.870 (95% CI: 0.835-0.905). After 1000 bootstrap resamplings, AUC was 0.868, with 86.08% sensitivity and 72.65% specificity, outperforming each marker alone. Sensitivity analysis confirmed robustness.
CONCLUSION: Elevated vaginal S100A8/A9 and sSDC1 are independent risk factors for persistent HR-HPV infection and vaginal dysbiosis. Combined testing (AUC=0.870) may aid risk stratification. This single-center exploratory study lacked HPV-negative controls and external validation, requiring multicenter confirmation.
METHODS: In this prospective cohort study, 403 HR-HPV--positive patients without cervical intraepithelial neoplasia grade 2 or worse were enrolled between April 2023 and February 2024. Genotypes included HPV 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, 66, and 68, 12 of which are Group 1 carcinogens per the International Agency for Research on Cancer (IARC). Over 2 years, 245 cleared and 158 had persistent infection. Enzyme-linked immunosorbent assay measured S100A8/A9 and sSDC1 levels. Spearman correlation assessed relationships with viral load and vaginal pH. LASSO regression screened variables, followed by multivariable logistic regression. Receiver operating characteristic (ROC) curves evaluated predictive performance.
RESULTS: In the persistent infection group, HPV16 (39.87%) and HPV18 (22.78%) predominated. S100A8/A9, sSDC1, and dysbiosis indicators were higher in the persistent group (all P<0.05). S100A8/A9 and sSDC1 correlated positively with viral load (r=0.351 and 0.364) and vaginal pH (r=0.475 and 0.422; all P<0.001). Multivariable analysis identified elevated viral load and vaginal pH, abnormal microecological indicators, and elevated S100A8/A9 (odds ratio [OR]=1.070, 95% confidence interval [CI]: 1.002-1.141) and sSDC1 (OR=1.424, 95% CI: 1.045-1.941) as independent risk factors (all P<0.05). Combined testing yielded an area under the curve (AUC) of 0.870 (95% CI: 0.835-0.905). After 1000 bootstrap resamplings, AUC was 0.868, with 86.08% sensitivity and 72.65% specificity, outperforming each marker alone. Sensitivity analysis confirmed robustness.
CONCLUSION: Elevated vaginal S100A8/A9 and sSDC1 are independent risk factors for persistent HR-HPV infection and vaginal dysbiosis. Combined testing (AUC=0.870) may aid risk stratification. This single-center exploratory study lacked HPV-negative controls and external validation, requiring multicenter confirmation.