尖锐湿疣皮损中树突状细胞分子表型的临床意义

Clinical Significance of the Molecular Phenotype of Dendritic Cells in Condyloma Acuminatum Lesions

目的检测尖锐湿疣(CA)皮损中树突状细胞CD1a,CD83,CD80和CD86的表达情况,并探讨其分子表型在CA发病中的作用及其与HPV亚型的相关性。方法采用HPV基因分型试剂盒检测CA患者所感染的HPV亚型,用免疫组化方法检测41例CA和32例正常包皮组织中CD1a,CD83,CD80和CD86的表达情况。结果 CA组织表皮CD1a阳性细胞数显著高于正常包皮组,且长病程组高于短病程组,高危型HPV感染组显著高于低危型HPV感染组,复发组略高于初发组,但差别无统计学意义。CA组织表皮内CD83阳性细胞数显著高于正常包皮组,CA组中,CD83表皮阳性细胞数与CD1a表皮阳性细胞数呈正相关,但较后者显著减少。CA组织表皮内CD80/CD86阳性细胞数与正常包皮组差异无统计学意义。结论 CA组织表皮中的树突状细胞大部分处于未成熟状态,缺乏共刺激分子(如CD80/CD86)的表达,尤其是伴有高危型HPV感染的病例,这可能是导致HPV抗原提呈障碍,从而造成CA复发及病程延长的免疫学机制之一。

Objective To detect the expression of CD1a,CD83,CD80 and CD86 in dendritic cells（DCs）in condyloma acuminatum（ CA）lesions, in order to investigate the possible roles of the molecular phenotype of DCs in the progression of CA and the relationship with human papillomavirus（ HPV）subtypes.Methods HPV genotyping kit was used to detect the HPV subtypes in the patients with CA.The expression of CD1a,CD83,CD80 and CD86 in DCs of 41 CA lesions and 32 normal foreskins were detected by EnVision immunohistochemical method.Results The number of CD1a positive DCs was greater in CA lesions than that in normal foreskin tissue of the healthy control group.Among the CA patients, the number of CD1a positive DCs was significantly higher in the long course CA group than in the short course CA group,and it was higher in high-risk HPV CA group than low-risk HPV CA group.It was slightly higher in the relapsed CA group compared with that in the first onset CA group,but no statistical significance was found.The number of CD83 positive DCs was greater in CA lesions than that in normal foreskin tissue of the healthy control group.In CA lesions, the number of CD83 positive DCs was correlated with the number of CD1a positive DCs,but it is significantly lower than the latter.No significant difference was found in the number of CD80/CD86 positive DCs between the CA group and the healthy control group.Conclusion Most of the DCs in CA lesions were immature and short of expression of co-stimulatory molecules（CD80 and CD86）, especially in CA cases with high-risk HPV subtypes, which may be one of the immunological mechanisms leading to the disability of presentation of HPV antigens, resulting in CA relapse and prolonged course of disease.