中晚期宫颈癌患者放化疗前后HPV感染与T细胞变化的相关性

Correlation Between T cell Alteration and HPV Infection Before and After Chemoradiotherapy in Patients with Advanced Cervical Cancer

目的:本研究旨在检测宫颈癌患者放化疗前后外周血和宫颈组织中T细胞亚群的变化规律,研究放化疗前后患者机体免疫功能状态的改变,并探讨对中晚期宫颈癌患者进行适时、合理免疫治疗的临床意义。方法:采用流式细胞仪检测(flow cytometry,FCM)分析2010年1月～2011年9月我院收治的60例维吾尔族宫颈癌患者放化疗前后外周血中CD3+、CD4+、CD8+和CD4+CD25+T细胞百分数;免疫组织化学SP法检测宫颈组织中CD3+TILs、CD4+TILs、CD8+TILs、Treg细胞的分布情况;HPV检测。结果:宫颈癌患者外周血中放化疗前组CD3+、CD4+、CD8+和CD4+CD25+T细胞百分数及Foxp3mRNA(相对量)比值分别为(67.23±5.21)%、(31.30±4.11)%、(34.77±6.41)%、(10.81±1.60)%、0.318±0.027;放化疗后组各指标分别为:(70.89±5.52)%、(35.42±4.72)%、(29.85±6.02)%、(6.96±0.94)%、0.266±0.028;宫颈组织中放化疗前组CD3+、CD4+、CD8+和CD25+T细胞百分数及Foxp3:(49.22±4.32)%、(30.02±4.93)%、(38.13±2.21)%、(12.66±1.78)%、60.18±5.02;放化疗后各指标分别为:(53.11±4.49)%、(36.12±4.21)%、(31.65±1.93)%、(7.87±1.14)%、40.26±4.88;HPV半定量放化疗前(581±22%),放化疗后(154±19%)。结论:中晚期维吾尔族宫颈癌患者放化疗后免疫功能有好转趋势,但均未能恢复到正常水平,且免疫功能与HPV感染呈正相关。

OBJECTIVE： The purpose of this study is to detect changes of peripheral blood T cell subsets of pa- tients with advanced cervical cancer, study the changes of the immune function, investigate the clinical significance of timely and reasonable immunotherapy in patients with advanced cervical cancer. METHODS： The proportions of CD3 ＋, CD4 ＋, CD8 ＋ and CD4 ＋ CD25 ＋？T ceils and Immunohistochemical SP method in the detection of cervical tissue CD3＋TILs, CD4＋TILs, CD8＋TILs, Treg ceils distribution in peripheral blood of 60 Uighur patients with cervical cancer before and after radiotherapy and chemotherapy, hospitalized from Jan. 2010 to Sep. 2011, were detected by flow cytometry （FCM） and the HPV subtypes detect. RESULTS ： The proportions of CD3＋, CD4＋ , CD8＋ , CD4＋CD25＋ T cells and Foxp3mRNA were （67.23±5.21）%, （31.30 ±4.11）%, （34.77± 6.41）%, （10.81± 1.60）%, and 0.318 ± 0.027 in patients with advanced cervical cancer before radiotherapy and chemotherapy, and （70.89 ± 5.52）%, （35.42 ± 4.72）%, （29.85 ± 6.02）%, （6.96 ± 0.94）% and 0.266 ± 0.028 in patients with advanced cervical cancer after radiotherapy and chemotherapy;The proportions of CD3＋, CD4＋, CD8＋, CD25＋!T cells and Foxp3 were （49.22 ± 4.32）%, （30.02 ± 4.93）%, （38.13 ± 2.21）%, （12.66 ± 1.78）% ,60.18 ± 5.02 in patients with cervical tissue group before radiotherapy and chemotherapy,and （53.11 ± 4.49）%, （36.12 ± 4.21）%, （31.65 ± 1.93）%, （7.87 ±1.14）%,40.26 ± 4.88 after radiotherapy and chemotherapy .the positive expression of HPV eases in radiotherapy be- fore and after the treatment groups respectively： （581± 22 % ）, （ 154 ± 19 % ）. CONCLUSIONS ： the immune func- tion in advanced cervical cancer patients after radiotherapy and chemotherapy have improved the trend, but failed to return to normal levels, and the immune function was correlated with HPV infection.