宫颈上皮内瘤变合并HR-HPV感染外周血T淋巴细胞亚群、调节性T细胞检测及其临床意义

The detection and significance of T lymphocyte subsets and regulatory T cells in peripheral blood of patients with cervical intraepithelial neoplasia complicated with HR-HPV infection

目的:探究宫颈上皮内瘤变(CIN)合并高危型人乳头瘤病毒(HR-HPV)感染患者外周血T淋巴细胞亚群、调节性T细胞的临床检测及意义。方法:对192例CIN合并HR-HPV感染患者行HPV DNA载量检测及外周血T淋巴细胞亚群、调节性T细胞检测。比较不同CIN级别患者HPV DNA载量水平及分布,对不同CIN级别和不同HPV DNA载量患者外周血T淋巴细胞亚群及调节性T细胞水平进行对比分析。对CIN级别、HPV DNA载量与T淋巴细胞亚群、调节性T细胞进行Pearson相关性分析。结果:CIN级别越高,HPV DNA载量越高,不同CIN级别患者HPV DNA载量水平及分布存在显著差异(P<0.05)。CIN级别越高,其CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平越低,CD8^(+)、CD4^(+)CD25^(+)CD127^(-)水平越高;不同CIN级别、不同HPV DNA载量水平患者在外周血T淋巴细胞亚群及调节性T细胞水平上比较,差异有统计学意义(P<0.05)。Pearson结果显示,CIN级别、HPV DNA载量与CD3^(+)、CD4^(+)、CD4^(+)/CD8^(+)水平呈负相关(P<0.05),与CD8^(+)、CD4^(+)CD25^(+)CD127^(-)水平呈正相关(P<0.05)。结论:随HR-HPV感染CIN级别越高,外周血T淋巴细胞亚群、调节性T细胞的表达异常愈加明显,在CIN的发生、发展及肿瘤免疫逃逸过程中发挥重要作用。联合检测外周血T淋巴细胞亚群及调节性T细胞表达情况对病情预测、免疫治疗等方面具有重要意义。

Objective:To research the clinical detection and significance of T lymphocyte subsets and regulatory T cells in peripheral blood of patients with cervical intraepithelial neoplasia complicated with HR-HPV infection.Methods:192 cases of CIN combined with HR-HPV were tested for HPV DNA load,peripheral blood T lymphocyte subsets and regulatory T cells.The levels and distribution of HPV DNA load in patients with different CIN levels were compared,and the peripheral blood T lymphocyte subsets and regulatory T cell levels in patients with different CIN levels and different HPV DNA loads were compared and analyzed.Pearson correlation analysis was performed among CIN level,HPV DNA load,T lymphocyte subsets and regulatory T cells.Results:The patients with higher CIN level,the HPV DNA load was higher,and there were significant differences in the level and distribution of HPV DNA load in patients with different CIN levels(P<0.05).The patients with higher CIN level and higher HPV DNA load level had lower CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)levels,while higher CD8^(+)and CD4^(+)CD25^(+)CD127^(-)levels.The patients with different CIN levels and different HPV DNA load levels had statistically significant differences in peripheral blood T lymphocyte subsets and regulatory T cells(P<0.05).Pearson results showed that CIN level and HPV DNA load were negatively correlated with CD3^(+),CD4^(+)and CD4^(+)/CD8^(+)levels(P<0.05),while positively correlated with CD8^(+)and CD4^(+)CD25^(+)CD127^(-)levels(P<0.05).Conclusion:The higher the CIN level of HR-HPV infection,the more obvious the abnormal expression of T lymphocyte subsets and regulatory T cells in peripheral blood,which plays an important role in the occurrence,development and tumor immune escape of CIN.The combined detection of T lymphocyte subsets and regulatory T cells in peripheral blood is of great significance for the prognosis and immunotherapy of T lymphocyte.