阴道灌洗液中IL-6、IL-17、IFN-γ、TGF-β检测在宫颈高危型HPV感染患者中的临床意义

Clinical significance of detecting IL-6, IL-17, IFN-γ and TGF-β in vaginal lavage fluid on patients with cervical high-risk HPV infection

目的探讨阴道灌洗液中白细胞介素-6(IL-6)、白细胞介素-17(IL-17)、干扰素-γ(IFN-γ)、生长转化因子-β(TGF-β)检测在宫颈高危型人乳头瘤病毒(HR-HPV)感染患者中的临床意义。方法选取2018年1月~2019年12月我院收治的84例宫颈高危型HPV感染患者为研究组,根据患者病理组织检查结果分为3个亚组,宫颈癌患者为A组(n=27),宫颈上皮不典型增生(CIN)Ⅰ级患者为B组(n=29),CINⅡ、Ⅲ级患者为C组(n=28);根据患者HPV检测分型分为3个亚组,即HPV16组(n=31)、HPV18组(n=30)、其他组(n=23);选择同期来我院体检的84例健康成年人为对照组。比较研究组和对照组组间IL-6、IL-17、IFN-γ、TGF-β水平,比较不同病理结果患者HR-HPV负荷量,比较不同病理结果、不同HPV分型患者IL-6、IL-17、IFN-γ、TGF-β水平,使用Spearman法分析IL-6、IL-17、IFN-γ、TGF-β水平与宫颈HR-HPV感染患者HR-HPV负荷量的相关性。结果研究组IL-6、IL-17、TGF-β水平均高于对照组,IFN-γ水平低于对照组(P<0.05);不同病理结果患者HR-HPV负荷量比较,差异有统计学意义(P<0.05);B、C组IL-6、IL-17、TGF-β水平均低于A组,IFN-γ水平高于A组;C组IL-6、IL-17、TGF-β水平均高于B组,IFN-γ低于B组(P<0.05);HPV16组、HPV18组、其他组组间IL-6、IL-17、IFN-γ、TGF-β水平差异无统计学意义(P>0.05);HR-HPV患者阴道灌洗液细胞因子IL-6、IL-17、TGF-β与HR-HPV负荷量呈正相关(r=0.613、0.517、0.512,P<0.05),IFN-γ与HR-HPV负荷量呈负相关(r=-0.557,P<0.05)。结论检测HR-HPV感染患者阴道灌洗液中IL-6、IL-17、IFN-γ、TGF-β水平有助于判断患者病情,具有临床意义。

Objective To explore the clinial significance of detecting interleukin-6(IL-6),interleukin-17(IL-17),interferon-γ(IFN-γ)and transforming growth factor-β(TGF-β)in vaginal lavage fluid on patients with cervical high-risk human papillomavirus(HR-HPV)infection.Methods A total of 84 patients with cervical high-risk HPV infection admitted to our hospital from Jan 2018 to Dec 2019 were selected as study group.The patients in study group were divided into three subgroups according to the histopathological examination results,including patients with cervical cancer in group A(n=27),patients with cervical intraepithelial neoplasia(CIN)grade I in group B(n=29)and patients with CIN gradeⅡand gradeⅢin group C(n=28).According to the HPV detection classification,the patients were divided into three subgroups,including HPV16 group(n=31),HPV18 group(n=30)and other group(n=23).84 healthy adults who underwent physical examination during the same period were selected as control group.The levels of IL-6,IL-17,IFN-γand TGF-βwere compared between study group and control group,and the HR-HPV load was compared among the patients with different histopathological results.The levels of IL-6,IL-17,IFN-γand TGF-βwere compared among the patients with different histopathological results and different HPV classification.Spearman method was used to analyze the correlation between levels of IL-6,IL-17,IFN-γand TGF-βand HR-HPV load in patients with cervical HR-HPV infection.Results The levels of IL-6,IL-17 and TGF-βin study group were higher than those in control group,while the level of IFN-γwas lower than that in control group(P<0.05).There was statistically significant difference in the HR-HPV load among patients with different histopathological results(P<0.05).The levels of IL-6,IL-17 and TGF-βin groups B and C were lower,the level of IFN-γwas higher than that in group A(P<0.05).The levels of IL-6,IL-17 and TGF-βin group C were higher,the level of IFN-γwas lower than that in group B(P<0.05).There were no significant differences in the levels of IL-6,IL-17,IFN-γand TGF-βamong HPV16 group,HPV18 group and other group(P>0.05).IL-6,IL-17 and TGF-βin vaginal lavage fluid were positively correlated with HR-HPV load of patients with HR-HPV infection,and IFN-γwas negatively correlated with HR-HPV load(P<0.05).Conclusion The detection of IL-6,IL-17,IFN-γand TGF-βlevels in vaginal lavage fluid of patient with HR-HPV infection is helpful for judging the disease condition of patients and has clinical significance.