维吾尔族宫颈癌患者手术前后HPV感染与Th17/Treg细胞的相关性

Correlation of Th17 / Treg cells and HPV infection before and after operation in patients with Uyghur cervical cancer

目的探讨维吾尔族宫颈癌患者手术前后人乳头瘤病毒(HPV)与外周血CD+4IL17+Th17细胞、CD+4CD+25调节性T(Treg)细胞、IL-6、IL-23、IL-17、TGF-β、IL-10细胞因子的相关性。方法收集2014年12月-2015年12月就诊新疆医科大学第一附属医院妇科宫颈HPV感染的维吾尔族宫颈病变患者共60例,宫颈癌(CC组)30例,子宫上皮内瘤变(CINⅡ~Ⅲ组)30例。分别于手术前及手术3个月后检测宫颈HPV、外周血T细胞亚群(CD+4CD+25Treg细胞、CD+4IL17+Th17细胞的含量)、血清IL-6、IL-23、IL-17、TGF-β、IL-10的表达水平。HPV检测采用HPV核酸扩增分型检测试剂盒,T细胞亚群采用流式细胞仪技术,酶联免疫吸附剂测定(ELISA)检测相关细胞因子。结果 (1)手术治疗CC及CINⅡ~Ⅲ患者后HPV转阴明显升高,CC组HPV转阴率为60%,CINⅡ~Ⅲ组HPV转阴率为53%;(2)CC组和CINⅡ~Ⅲ组手术后外周血CD+4IL17+Th17%、CD+4CD+25Treg%、Th17/Treg比率及相关细胞因子均低于手术前,差异有统计学意义(P<0.01);(3)CC组与CINⅡ~Ⅲ组对照,术前及术后CD+4IL17+Th17%、CD+4CD+25Treg%、Th17/Treg比率CC组高于CINⅡ~Ⅲ组;(4)术后HPV持续阳性的CC患者外周血CD+4CD+25Treg%、CD+4IL17+Th17%及Th17/Treg比率表达水平高于术后HPV转阴的CC患者,差异有统计学意义(P<0.05)。结论手术治疗宫颈癌及子宫颈上皮内瘤变后,宫颈HPV的感染率、CD+4CD+25Treg细胞、CD+4IL17+Th17细胞、Th17/Treg细胞及相关细胞因子降低,Th17/Treg细胞失衡可能直接参与宫颈HPV感染的免疫逃避,并与病情发展相关。术后监测外周血Th17、Treg细胞可能成为宫颈癌患者病情进展及复发的指标之一。

Objective To investigate the correlation between human papilloma virus （HPV）and peripheral blood CD＋4 IL17＋ Th17 cells,CD＋4 CD＋25 regulatory T cells （Treg）,IL-6,IL-23,IL-17,TGF-βand IL-10 cytokines of Uyghur cervical cancer before and after surgery.Methods A total of 60 patients with cervical HPV infection selected from the First Affiliated Hospital at Xinjiang medical university between December＆amp;nbsp;2014 and December 2015 were divided into cervical cancer （CC,n=30）group,cervical intraepithelial neo-plasia （CINⅡ-Ⅲ,n=30）group.Cervical HPV virus,peripheral blood T cell subsets （CD＋4 IL17＋ Th17 cells and CD＋4 CD＋25 Treg cells）and the expression of IL-6,IL-23,IL-17,TGF-βand IL-10 cytokines were detected before the operation and after three months of operation by HPV DNA amplification parting de-tection kit,flow cytometry instrument technology and Enzyme-linked immune sorbent assay （ELISA）re-spectively.Results After surgical treatment for patients with CC and CINⅡ-Ⅲ,HPV overcast signifi-cantly increased,the CC group was 60%,while the CINⅡ-Ⅲ group was 53%.For own comparisons,ex-pressions of CD＋4 IL17＋ Th17%,CD＋4 CD＋25 Treg%,Th17/Treg and related cytokines after surgery were lower than before （P 〈0.01）.The level of CD＋4 IL17＋ Th17 cells,CD＋4 CD＋25 Treg cells and the ratio of Th1 7/Treg in the CC group were significantly higher than those in the CINⅡ-Ⅲ group.The expressions of CD＋4 IL17＋ Th17 cells,CCD＋4 CD＋25 Treg cells and Th17/Treg in CC patients with HPV continuous positive were higher than those in the HPV negative group （P 〈0.05）.Conclusion After surgical treatment for cervical cancer and cervical intraepithelial neoplasia,cervical HPV infection rates,CD＋4 IL1 7＋ Th1 7%, CD＋4 CD＋25 Treg%,Th17/Treg and related cytokines were significantly falling.Imbalance of Th17/Treg cells may directly participate in the immune escape of cervical HPV infection,and is associated with disease progression.Monitoring of peripheral blood Th17,Treg cells may become one of the indicators of disease progression and recurrence.