宫颈癌患者外周血中调节性 T 细胞的变化及其临床意义

Changes of CD4＋ CD25＋ CD127low regulatory T cells in peripheral blood samples collected from the patients with cervical cancer and its clinical significance

目的 探讨宫颈癌患者外周血中CD4＋ CD25＋ CD127low调节性T 细胞（ regulatory T cells,Treg）的变化和临床意义,及其与高危型人乳头状瘤病毒（ high-risk human papillomavirus , HR-HPV）感染的相关性. 方法 采用流式细胞术检测249例宫颈癌患者、30例宫颈上皮内瘤变（ cervical intraepithelial neoplasia ,CIN）患者、60例健康对照者外周血中Treg细胞占CD4＋T细胞的比例,分析宫颈癌患者不同临床病理参数下CD4＋ CD25＋ CD127low Treg细胞含量的差异. 采用导流杂交基因芯片技术检测上述检查对象的生殖道HPV感染状况,分析CD4＋ CD25＋ CD127low Treg细胞与HR-HPV感染的相关性.结果 宫颈癌患者、CIN患者外周血CD4＋ CD25＋ CD127low Treg细胞占CD4＋T细胞的比例、HR-HPV感染率均较对照组显著升高,差异均有统计学意义（P〈0.01）. 宫颈癌患者外周血中,CD4＋ CD25＋ CD127low Treg细胞占CD4＋T细胞的比例与宫颈癌的临床分期、组织分化程度显著相关（ P〈0.05）. HR-HPV阳性组CD4＋ CD25＋ CD127low Treg占CD4＋T细胞比例较HR-HPV阴性显著升高,差异具有统计学意义（P〈0.01）. 结论 外周血中CD4＋ CD25＋ CD127low Treg细胞与宫颈癌的发生发展密切相关,可能成为判断宫颈癌恶性程度的指标;CD4＋ CD25＋ CD127low Treg细胞与HR-HPV持续感染密切相关.

Objective To investigate the changes of CD4＋ CD25＋ CD127low regulatory T cells （Treg） in peripheral blood samples collected from the patients with cervical cancer and its clinical signifi -cance , and to evaluate the correlations between Treg cells and the infection of high-risk human papillomavir-us （ HR-HPV） .Methods Flow cytometry analysis was performed to measure the percentages of CD4＋ CD25＋ CD127low Treg cells among CD4＋T cells in peripheral blood samples collected from 249 patients with cervical cancer , 30 patients with cervix intraepithelial neoplasia （ CIN） and 60 healthy subjects .The corre-lations between the levels of Treg cells and the clinicopathological features of cervical cancer were analyzed . Flow-through hybridization and gene chip technology （ HybriMax） were used to analyze the genotypes of HPV strains isolated from the 339 subjects.The correlations between Treg cells and HR-HPV infection were ana-lyzed.Results Compared with the healthy subjects , the patients with cervical cancer or CIN showed higher percentages of CD4＋ CD25＋ CD127low Treg cells and rates of HR-HPV infection （P〈0.01）.The percentages of CD4＋ CD25＋ CD127low Treg cells in patients with cervical cancer were significantly correlated with the sta-ges of cervical cancer , which was staged by the Federation International of Gynecology and Obstetrics （FIGO） staging system,and the degrees of differentiation （P〈0.05）.The percentages of CD4＋ CD25＋ CD127low Treg cells in the peripheral blood of patients with positive HR-HPV were significantly higher than those in patients without HR-HPV infection （P〈0.01）.Conclusion The CD4＋ CD25＋ CD127low Treg cells in peripheral blood might play an important role in the oncogenesis and development of cervical carcinoma , thus it could be used as a potential marker for the evaluation of disease progression .Moreover , the CD4＋ CD25＋ CD127low Treg cells were closely related to the HR-HPV infection.