宫颈上皮内瘤样病变及宫颈癌患者HPV16、18型感染对阴道局部免疫功能的影响

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英文篇名：Effect of human papillomavirus type 16 and 18 infection on the cellular immune function in patients with cervical intraepithelial neoplasia and cervical cancer 作者：韩华 ; 陈闻月 ; 周红儿 英文作者：HAN Hua;CHEN Wenyue;ZHOU Honger;Department of Gynaecology,the First People's Hospital of Fuyang,Hangzhou; 关键词：人乳头状瘤病毒 ; 宫颈上皮内瘤样病变 ; 宫颈癌 ; T淋巴细胞亚群细胞因子 ; 免疫功能 英文关键词：human papilloma virus;;cervical intraepithelial neoplasia;;cervical cancer;;T lymphocyte subsets cytokines;;cellular immune function 中文刊名：QKYL 英文刊名：Clinical Education of General Practice 机构：杭州市富阳区第一人民医院妇科; 出版日期：2019-02-28 出版单位：全科医学临床与教育 年：2019 期：v.17 基金：杭州市农业与社会发展科研项目(20163501Y104) 语种：中文; 页：QKYL201902009 页数：3 CN：02 ISSN：33-1311/R 分类号：34-36

摘要

目的探讨人乳头状瘤病毒(HPV)16、18型感染对宫颈疾病患者相关细胞免疫功能的影响。方法选择不同宫颈疾病患者且HPV16、18型阳性30例作为研究对象(HPV组),另取健康体检女性且液基细胞学检查及HPV均阴性33例作为对照组。采用流式细胞仪检测阴道局部分泌物CD~(4+)T淋巴细胞、CD~(8+)T淋巴细胞,并计算CD~(4+)/CD~(8+)比值;采用ELISA法检测肿瘤坏死因子(TNF-α)、白介素2(IL-2)、IL-4、IL-6水平。结果 HPV组患者CD~(4+)T浓度、CD~(4+)/CD~(8+)比值明显低于对照组,差异有统计学意义(Z分别=-2.78、-4.93,P均<0.05);而两组患者CD~(8+)T浓度比较,差异无统计学意义(Z=-0.60,P>0.05)。HPV组患者CD~(4+)/CD~(8+)比值≤1的比例明显高于对照组,差异有统计学意义(X~2=27.07,P<0.05)。HPV组患者IL-2水平明显低于对照组,而IL-4水平明显高于对照组,差异均有统计学意义(t分别=17.65、9.50,P均<0.05)。而两组患者IL-6和TNF-α水平比较,差异均无统计学意义(t分别=0.14、0.59,P均>0.05)。结论 HPV16、18型感染可能导致患者细胞免疫低下,持续性HPV感染引起宫颈癌前病变及宫颈癌。
        Objective To investigate the effect of human papillomavirus(HPV) type 16 and 18 infection on the cellular immune function in patients with cervical diseases. Methods Thirty patients with different cervical diseases and positive HPV16 and 18 were selected as the HPV group. Thirty-three healthy women with negative HPV and negative liquid-based cytology were selected as the control group.Flow cytometry was used to detect CD~(4+)T lymphocyte and CD~(8+)T lymphocyte in local vaginal secretion,and the ratio of CD~(4+)/CD~(~(8+))was calculated.The levels of TNF-α,IL-2,IL-4 and IL-6 were detected by ELISA. Results The concentration of CD~(4+)T lymphocyte and the proportion of CD~(4+)/CD~(~(8+))in HPV group were significantly lower than those in control group(Z=-2.78,-4.93,P<0.05),but there was no significant difference in the concentration of CD~(~(8+))T lymphocyte between the two groups(Z=-0.60,P>0.05). The proportion of CD~(4+)/CD~(~(8+))<1 in HPV group was significantly higher than that in control group(X~2=27.07,P<0.05).The level of IL-2 in HPV group was significantly lower than that in control group,while the level of IL-4 was significantly higher than that in control group(t=17.65,9.50,P<0.05).There was no significant difference in the levels of IL-6 and TNF-α between the two groups(t=0.14,0.59,P>0.05). Conclusion The HPV16 and 18 infection may lead to low cellular immunity hypofunction in the vagina,and persistent HPV infection may cause cervical precancerous lesions and cervical cancer.

引文

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