宫颈癌合并阴道炎患者病原菌感染情况及Th17细胞和血清细胞因子的变化

Pathogen infection and changes in Th17 cells and serum cytokines in patients with cervical cancer and vaginitis

目的探究宫颈癌合并阴道炎患者病原菌感染情况及阴道局部辅助性T细胞17(Th17)的细胞免疫功能及血清因子变化。方法选取2018年1月-2021年1月本院收治的152例新发宫颈癌患者,根据是否合并阴道炎分为阴道炎组(54例)和对照组(98例),比较两组患者阴道分泌物中病原菌检出情况、HPV感染情况,以及Th17细胞和细胞因子(IL-17,IL-10,TGF-β)水平。结果阴道炎组检出阴道致病菌感染者37例(68.52%),对照组检出致病菌感染者46例(46.94%),两组比较差异有统计学意义(χ^(2)=6.541,P=0.011)。阴道炎组共分离病原菌49株,其中革兰阴性菌15株(30.61%)、革兰阳性菌9株(18.37%)、真菌25株(51.02%)。对照组共分离病原菌47株,其中革兰阴性菌24株(51.06%)、革兰阳性菌11株(23.40%)、真菌12株(25.53%),两组阴道真菌、革兰阴性菌及革兰阳性菌的构成比差异有统计学意义(χ^(2)=6.806,P=0.033)。阴道炎组HPV16、HPV18感染占比均显著高于对照组(均P<0.05),Th17细胞、IL-6、IL-10、IL-17A、TGF-β表达水平高于对照组(P<0.05或P<0.01)。结论宫颈癌合并阴道炎患者阴道感染病菌分布广泛,以真菌为主。患者阴道局部Th17细胞及血清因子水平偏高,能在一定程度上影响HPV感染和宫颈癌进程。

Objective To explore pathogen infection and changes in the cellular immune function of T helper 17 cells(Th17) in the vagina and serum factors in patients with cervical cancer and vaginitis. Methods Subjects were a total of 152 new patients with cervical cancer seen at this Hospital from January 2018 to January 2021. Patients were divided into a vaginitis group(n=54) and a control group(n=98) depending on whether or not they had vaginitis. The detection of pathogens, HPV infection, and the levels of Th17 cells and cytokines(IL-17, IL-10, and TGF-β) in vaginal secretions from the two groups of patients were compared. Results A vaginal infection was detected in 37 patients(68.52%) in the vaginitis group and in 46(46.94%) in the control group, and the rate of vaginal infection differed significantly between the two groups(χ^(2)=6.541, P=0.011). Forty-nine strains of pathogens were isolated from the vaginitis group, including 15 strains(30.61%) of Gram-negative bacteria, 9 strains(18.37%) of Gram-positive bacteria, and 25 strains(51.02%) of fungi. A total of 47 strains of pathogens were isolated from the control group, including 24 strains(51.06%) of Gram-negative bacteria, 11 strains(23.40%) of Gram-positive bacteria, and 12 strains(25.53%) of fungi. The proportion of vaginal fungi, Gram-negative bacteria, and Gram-positive bacteria differed significantly between the two groups(χ^(2)=6.806, P=0.033). The rates of infection with HPV16 and HPV18 in the vaginitis group were higher than those in the control group(χ^(2)=3.959, 4.507, P<0.05). The level of expression of Th17 cells, IL-6, IL-10, IL-17 A, and TGF-β in the vaginitis group was higher than that in the control group(t=2.202, 2.235, 2.054, 4.425, and 2.788, P<0.05). Conclusion Patients with cervical cancer and vaginitis have a wide variety of vaginal infections. Fungi are mainly responsible for those infections. The local level of Th17 cells and serum factors was markedly higher in the vagina of patients, and this can affect the progression of HPV infection and cervical cancer to a certain extent.