重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术对宫颈癌前病变患者T淋巴细胞的影响

Effect of recombinant human interferonα-2b gel assisted high-frequency loop electrosurgical excision procedure on T lymphocytes in patients with cervical precancerous lesions

目的探讨重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术对宫颈癌前病变患者T淋巴细胞的影响。方法选取2019年2月至2023年2月如皋市人民医院接收的70例高级别鳞状上皮内病变(HSIL)患者为研究对象,通过随机数字表法分为对照组(n=35)与观察组(n=35),对照组予以高频电刀宫颈环切术治疗,观察组予以重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术治疗。比较两组患者人乳头瘤病毒(HPV)转阴率、治疗前后的HPV病毒载量、T淋巴细胞水平[CD3阳性细胞(CD3^(+))、CD4阳性细胞(CD4^(+))、CD8阳性细胞(CD8^(+))、CD4^(+)/CD8^(+)]、肿瘤标志物[癌胚抗原199(CA199)、细胞角蛋白19(CK19)、鳞状细胞癌抗原(SCCA)]、炎症因子[肿瘤坏死因子α(TNF-α)、白细胞介素6(IL-6)]水平差异,并对比两组术后并发症发生情况。结果治疗前,观察组与对照组在HPV病毒载量、T淋巴细胞水平、肿瘤标志物、炎症因子水平方面的差异均无统计学意义(P>0.05)。治疗后,两组的HPV病毒载量均显著低于治疗前水平(P<0.05),且观察组治疗后的病毒载量显著低于对照组(P<0.05),观察组患者的HPV转阴率显著高于对照组(P<0.05);两组CD3^(+)和CD4^(+)水平及CD4^(+)/CD8^(+)比治疗前均上升,且观察组显著高于对照组(P<0.05),两组CD8^(+)水平均有下降,且观察组显著低于对照组(P<0.05);两组CA199、CK19、SCCA水平以及TNF-α、IL-6水平较治疗前均显著下降(P<0.05),且观察组显著低于对照组(P<0.05)。观察组中阴道出血、感染及宫颈粘连的总发生率显著低于对照组(2.86%vs.17.14%,P<0.05)。结论重组人干扰素α-2b凝胶辅助高频电刀宫颈环切术可以显著提高HSIL患者的HPV转阴率,降低HPV病毒载量,调整T淋巴细胞水平,降低肿瘤标志物和炎症因子水平,减少术后并发症,是一种有效的治疗方法。

Objective:To explore the effects of recombinant human interferonα-2b gel assisted high-frequency loop electrosurgical excision procedure(LEEP)on T lymphocytes in patients with cervical precancerous lesions.Methods:From February 2019 to February 2023,70 high-grade squamous intraepithelial lesions(HSIL)patients treated at Rugao People’s Hospital were randomly divided into a control group(n=35)and an observation group(n=35).The control group was treated with LEEP,and the observation group was treated with recombinant human interferonα-2b gel assisted LEEP.The HPV clearance rate,HPV viral load before and after treatment,T lymphocyte levels including CD3^(+),CD4^(+),CD8^(+),CD4^(+)/CD8^(+),tumor markers including carbohydrate antigen 199(CA199),cytokeratin 19(CK19)and squamous cell carcinoma antigen(SCCA),and levels of inflammatory factors including tumor necrosis factor(TNF)-αand interleukin(IL)-6 were compared between the two groups,as well as postoperative complications.Results:Before treatment,there were no significant differences in HPV viral load,T lymphocyte levels,tumor markers,and inflammatory factor levels between the observation and control groups(P>0.05).After treatment,the HPV viral load significantly decreased in both groups(P<0.05),with the observation group showing a significantly lower viral load than the control group(P<0.05).The HPV clearance rate was significantly higher in the observation group(P<0.05).Both groups showed an increase in levels of CD3^(+),CD4^(+),CD4^(+)/CD8^(+),with the observation group being significantly higher than the control group(P<0.05).Both groups showed a decrease in CD8^(+),with the observation group being significantly lower than the control group(P<0.05).Levels of CA199,CK19,SCCA,TNF-αand IL-6 decreased in both groups(P<0.05),with the observation group being significantly lower than the control group(P<0.05).Furthermore,the incidence of vaginal bleeding,infection,and cervical adhesion in the observation group was 2.86%,lower than that in the control group(17.14%),with all comparative differences being significant(P<0.05).Conclusions:Recombinant human interferonα-2b gel assisted LEEP can significantly improve the HPV clearance rate,reduce HPV viral load,adjust T lymphocyte levels,decrease tumor markers and inflammatory factor levels,and reduce postoperative complications,proving to be an effective treatment method.