sICOS和sPD-1在HR-HPV感染、CIN及宫颈癌中的表达及临床意义

The Expression and Significance of sICOS/sPD-1 among the HR-HPV Infection and CIN and Cervical Cancer

目的:探讨可溶性共刺激分子(sICOS)和可溶性程序性死亡蛋白1(sPD-1)在HR-HPV感染、CIN及宫颈癌间的表达差异及临床意义。方法:将240例高危型人乳头状瘤病毒(HR-HPV)感染患者分为HR-HPV感染组80例、CIN组80例、宫颈癌组80例,同时选取80例健康体检者作为对照组,通过酶联免疫吸附试验(ELISA)方法检测各组外周血中sPD-1、sICOS的表达情况,并应用SPSS26.0软件进行统计学分析。结果:与健康对照组相比,CIN组、宫颈癌组的sPD-1表达水平均升高,差异具有统计学意义(P<0.01),而HR-HPV感染组与健康组血清中sPD-1表达水平的差异无统计学意义(P>0.05);与健康对照组相比,各病例组血清中sICOS水平均升高,较健康对照组差异具有统计学意义(P<0.01),但HR-HPV感染组与CIN组血清中sICOS表达水平的差异无统计学意义(P>0.05);研究对象的血清中sICOS和sPD-1呈正相关关系(r=0.755,P<0.01),其中HR-HPV组、CIN组、宫颈癌组的sICOS和sPD-1间均有显著的正相关关系(P<0.01),而健康组的sICOS和sPD-1无相关关系(P>0.05);ROC分析sPD-1、sICOS对HR-HPV、CIN、宫颈癌的鉴别效能,AUC分别为0.8520、0.8364。结论:在HR-HPV感染后的免疫中,sPD-1和sICOS存在上调表达,且HR-HPV组、CIN组及宫颈癌组的sICOS与sPD-1的正相关关系显著,提示可能存在协同刺激,促进病原的免疫逃逸,影响疾病的发生发展。

Objective:To investigate the expression differences and clinical significance of soluble molecule programmed death 1(sPD-1)and soluble inducible costimulator(sICOS)among HR-HPV infection,CIN and cervical cancer.Methods:240 patients with high-risk human papilloma virus(HR-HPV)infection were divided into three case groups:80 patients with HR-HPV infection and no cervical lesions(HR-HPV infection group),80 patients with cervical intraep-ithelial neoplasia(CIN)and existing or past HR-HPV infection(CIN group),80 patients with cervical cancer and existing or past HR-HPV infection(cervical cancer group),80 healthy people were selected as the control group.The expressions of sPD-1 and sICOS was detected by enzyme-linked immuno sorbent assay(ELISA).SPSS26.0 software was used for statistical analysis.Results:Compared with healthy control group,the expression level of SPD-1 in CIN group and cervical cancer group were increased,the difference was statistically significant(P<0.01),but there was no significant difference in serum expression between HR-HPV infection group and healthy group(P>0.05).Compared with the healthy control group,the expression level of sICOS in case groups were increased,and the difference were statistically significant(P<0.01),but there was no significant difference in the expression between HR-HPV infection group and CIN group(P>0.05).There was a moderate positive correlation between sICOS and SPD-1 in the serum of the subjects(r=0.755,P<0.01).It was a significant correlation between sICOS and sPD-1 in HR-HPV group,CIN group and cervical cancer group(P<0.01),but no correlation between sICOS and sPD-1 in the healthy group(P>0.05).Conclusion:In the immunity after HR-HPV infection,the expression of sPD-1 and sICOS is up-regulated,and the correlation between sICOS and sPD-1 in HR-HPV group,CIN group and cervical cancer group is significant.It is suggested that there may be synergistic stimulation to promote the immune escape of pathogens,so as to affect the occurrence and development of diseases.