HPV感染对宫颈上皮内瘤样变患者阴道免疫细胞及炎性因子表达的影响

Effect of HPV infection on vaginal immune cells and expression of inflammatory factors in patients with cervical intraepithelial neoplasia

目的探讨不同类型人乳头瘤病毒(Human papilloma virus,HPV)感染对宫颈上皮内瘤样变患者阴道免疫细胞及炎性因子白细胞介素-2(Interleukin-2,IL-2)、IL-4、IL-10表达的影响。方法选择六安市人民医院妇科,2016年7月-2019年7月确诊为宫颈上皮内瘤样病变的患者85例作为研究对象,根据其宫颈上皮内瘤变(Cervical intraepithelial neoplasia,CIN)分期分为,CIN I组(n=36)、CINⅡ组(n=26)、CINⅢ组(n=23),另根据其HPV感染分型情况分为高危型HPV感染组(n=59)、低危型HPV感染组(n=8)及非HPV感染组(n=18)。对不同CIN分期HPV分型感染情况及不同HPV分型感染免疫球蛋白(IgG、IgM、IgA)、免疫细胞(CD4^+、CD8^+、CD4^+/CD8^+)及炎性因子IL-2、IL-4及IL-10水平进行检测。结果非HPV感染组IgG、IgM、IgA、CD8^+、IL-4、IL-10水平低于高危型HPV感染组及低危型HPV感染组(P<0.05),CD4^+、CD4^+/CD8^+、IL-2水平高于高危型HPV感染组及低危型HPV感染组,差异具有统计学意义(P<0.05)。结论 HPV感染会造成宫颈上皮内瘤样变患者阴道Th1/Th2免疫反应失衡,应加强宫颈上皮内瘤样变患者的HPV筛查,尽早开展治疗。

OBJECTIVE To investigate the effects of different types of HPV infection on the expression of vaginal immune cells and inflammatory factors IL-2, 4 and 10 in patients with cervical intraepithelial neoplasia. METHODS In the Obstetrics and Gynecology Department of Lu’an People’s Hospital from Jul. 2016 to Jul. 2019, 85 patients diagnosed with cervical intraepithelial neoplasia were enrolled as the research objects. They were divided into the CIN I group(n=36), CIN Ⅱ group(n=26) and CIN Ⅲ group(n=23), according to the high-risk HPV infection group(n=59), low-risk HPV infection group(n=8) and non-HPV infection group(n=18) the classification of their cervical intraepithelial neoplasia(CIN) stages, and were also divided into the according to the infection status of HPV. Immunoglobulin(IgG, IgM, IgA), immune cells(CD4^+, CD8^+, CD4^+/CD8^+) and levels of inflammatory factors(IL-2, IL-4 and IL-10) were detected in all groups. RESULTS The levels of IgG, IgM, IgA, CD8^+, IL-4, and IL-10 in the non-HPV infection group were significantly lower than that in the high-risk HPV infection group and low-risk HPV infection group(P<0.05);the levels of CD4^+, CD4^+/CD8^+ and IL-2 were significantly higher than that in the high-risk HPV infection group and the low-risk HPV infection group(P<0.05). CONCLUSION HPV infection can cause imbalance of vaginal Th1/Th2 immune response in patients with cervical intraepithelial neoplasia. HPV screening for patients with cervical intraepithelial neoplasia should be strengthened as soon as possible.