Vitamin D deficiency and hepatitis viruses-associated liver diseases:a literature review

The secosteroid hormone vitamin D has, in addition to its effects in bone metabolism also functions in the modulation of immune responses against infectious agents and in inhibiting tumorigenesis. Thus, deficiency of vitamin D is associated with several malignancies, but also with a plethora of infectious diseases. Among other communicable diseases, vitamin D deficiency is involved in the pathogenesis of chronic liver diseases caused by hepatitis B and C viruses(HBV, HCV) and high prevalence of vitamin D deficiency with serum levels below 20 mg/mL in patients with HBV and HCV infection are found worldwide. Several studies have assessed the effects of vitamin D supplementation on the sustained virological response(SVR) to interferon(IFN) plus ribavirin(RBV) therapy in HBV and HCV infection. In these studies, inconsistent results were reported. This review addresses general aspects of vitamin D deficiency and, in particular, the significance of vitamin D hypovitaminosis in the outcome of HBVand HCV-related chronic liver diseases. Furthermore,current literature was reviewed in order to understand the effects of vitamin D supplementation in combination with IFN-based therapy on the virological response in HBV and HCV infected patients.

Impact of sustained virologic response on chronic kidney disease progression in hepatitis C

AIM To determine how sustained virological response at 12 wk(SVR12) with direct acting antivirals(DAAs) for the treatment of hepatitis C virus(HCV) infection affects chronic kidney disease(CKD) progression. METHODS A retrospective analysis was performed in patients aged ≥ 18 years treated for HCV with DAAs at the VA Greater Los Angeles Healthcare System from 2014-2016. The treatment group was compared to patients with HCV from 2011-2013 who did not undergo HCV treatment, prior to the introduction of DAAs; the control group was matched to the study group in terms of age, gender, and ethnicity. Analysis of variance and co-variance was performed to compare means between SVR12 subgroups adjusting for co-variates.RESULTS Five hundred and twenty-three patients were evaluated. When comparing the rate of change in estimated glomerular filtration rate(e GFR) one-year after HCV treatment to one-year before treatment, patients who achieved SVR12 had a decline in GFR of 3.1 m L/min ± 0.75 m L/min per 1.73 m^2 compared to a decline in e GFR of 11.0 m L/min ± 2.81 m L/min per 1.73 m^2 in patients who did not achieve SVR12(P = 0.002). There were no significant clinical differences between patients who achieved SVR12 compared to those who did not in terms of cirrhosis, treatment course, treatment experience, CKD stage prior to treatment, diuretic use or other co-morbidities. The decline in e GFR in those with untreated HCV over 2 years was 2.8 m L/min ± 1.0 m L/min per 1.73 m^2, which was not significantly different from the e GFR decline noted in HCV-treated patients who achieved SVR12(P = 0.43).CONCLUSION Patients who achieve SVR12 have a lesser decline in renal function, but viral eradication in itself may not be associated improvement in renal disease progression.

Fatty liver in hepatitis C patients post-sustained virological response with direct-acting antivirals

AIM To determine steatosis and fibrosis prevalence in hepatitis C patients after a sustained virological response achieved with direct-acting antivirals.METHODS Transient elastography with controlled attenuation parameter(CAP) was used to assess hepatic steatosis post-sustained virological response(SVR);the CAP technology was not available in the United States at study initiation.Liver stiffness/fibrosis was measured before and 47 wk after treatment completion.Patients with genotype 3 and patients with cirrhosis were excluded.RESULTS One hundred and one patients were included in the study.Post-SVR there were decreases from baseline in alanine aminotransferase(ALT)(63.1 to 17.8 U/L),aspartate aminotransferase(51.8 to 21.5 U/L) and fibrosis score(7.4 to 6.1 k Pa)(P < 0.05).Post-SVR,48 patients(47.5%) had steatosis on CAP;of these,6.25% had advanced fibrosis.Patients with steatosis had higher body mass index(29.0 vs 26.1 kg/m2),glucose(107.8 vs 96.6 mg/d L),ALT(20.4 vs 15.3 mg/d L),CAP score(296.3 vs 212.4 d B/m) and fibrosis score(7.0 vs 5.3 k Pa);P < 0.05.Interestingly,compared to baseline,both patients with and without steatosis had change in fibrosis score post-SVR(7.7 k Pa vs 7.0 k Pa and 7.0 k Pa vs 5.3 k Pa);alternatively,(P < 0.05) and therefore patients with steatosis continued to have clinically significant stiffness(≥ 7 k Pa).CONCLUSION Fatty liver is very common in hepatitis C virus(HCV) patients post-SVR.These patients continue to have elevated mean fibrosis score(≥ 7 k Pa) compared to those without fatty liver;some have advanced fibrosis.Long term follow up is needed to assess steatosis and fibrosis in HCV patients post-SVR.

Vitamin D deficiency in chronic liver disease

Vitamin D is an important secosteroid hormone with known effect on calcium homeostasis,but recently there is increasing recognition that vitamin D also is involved in cell proliferation and differentiation,has immunomodulatory and anti-inflammatory properties.Vitamin D deficiency has been frequently reported in many causes of chronic liver disease and has been associated with the development and evolution of non-alcoholic fatty liver disease(NAFLD)and chronic hepatitis C(CHC)virus infection.The role of vitamin D in the pathogenesis of NAFLD and CHC is not completely known,but it seems that the involvement of vitamin D in the activation and regulation of both innate and adaptive immune systems and its antiproliferative effect may explain its importance in these liver diseases.Published studies provide evidence for routine screening for hypovitaminosis D in patients with liver disease.Further prospectives studies demonstrating the impact of vitamin D replacement in NAFLD and CHC are required.

Ebola virus disease: From epidemiology to prophylaxis

The outbreak of Ebola virus disease(EVD) continues to spread through West Africa. Since the first reported EVD in March 2014, the number of cases has increased rapidly, with the fatality rate of >50%. The most prevalent Ebola virus belongs to the species of Zaire ebolavirus, with a mortality rate as high as 90%. Although there were introduced cases in other continents, Africa is the endemic area where fruit bats and apes are suspected to be Ebola virus carriers. The virus might be transmitted from the host animals to humans if humans consume relative raw and contaminated meats; however, human-to-human transmission via close contact is the major route of current outbreaks. EVD happens at any seasons and affected people of any race in any age groups. Direct contact with body fluids of EVD patients and living in the contaminated environment greatly increase the risk of being infected. Transmission viaaerosol is less possible but the transmission via droplet is possible in humans. Thus, health care providers are facing danger of getting Ebola virus infection. So far, there are limited vaccines, drugs and/or therapies to prevent Ebola virus infection or treat EVD. Medical workers should follow the current standard prophylactic procedures. Military forces can orchestrate efficient care to mass EVD casualties. Although it is necessary to speed up the pace of developing effective vaccine and therapeutics for the prevention and treatment of EVD, public health prophylaxis is the most important issue at present to control the spread of this disease cost-effectively.

Metabolic and cardiovascular complications after virological cure in hepatitis C:What awaits beyond

The association between chronic hepatitis C(CHC)infection and extrahepatic manifestations(EHMs),particularly cardiometabolic diseases,has been extensively examined.However,there has still been insufficient evaluation for these EHMs after virological cure.Several multidirectional mechanisms have been proposed explaining the ability of hepatitis C virus(HCV)developing EHMs,cardiometabolic ones,as well as the effect of antiviral therapy to resolve these EHMs.Data on these manifestations after achieving sustained virologic response(SVR)are still conflicting.However,current evidence suggests that reversal of hepatic steatosis and its coexistent hypocholesterolemia after successful viral eradication led to unfavorable lipid profile,which increases cardiovascular disease(CVD)risk.Additionally,most observations showed that metabolic alterations,such as insulin resistance and diabetes mellitus(DM),undergo some degree of reduction after viral clearance.These changes seem HCV-genotype dependent.Interferon-based antiviral therapy and direct acting antiviral drugs were shown to minimize incidence of DM.Large epidemiological studies that investigated the effect of SVR on CVD showed great discrepancies in terms of results,with predominant findings indicating that CVD events decreased in patients with SVR compared to non-responders or untreated ones.In this review,we present a summary of the current knowledge regarding extrahepatic sequelae of CHC following SVR,which may have an impact on healthcare providers’clinical practice.

慢性乙型肝炎合并代谢相关脂肪性肝病患者病毒学特征的分层分析

目的分析不同分层的慢性乙型肝炎(CHB)合并代谢相关脂肪性肝病(MAFLD)患者的病毒学特征。方法回顾性选取2013年1月1日—2019年12月31日于首都医科大学附属北京佑安医院行经皮肝穿刺活检、未接受抗病毒治疗或接受治疗后停药6个月以上的CHB合并MAFLD患者131例和单纯CHB患者168例,比较两组患者的一般资料、血生化指标、病毒学指标;根据肝脏病理的炎症活动度(G)及肝纤维化分期(S)对两组患者进行分层,并依据肝脂肪变性程度及非酒精性脂肪性肝炎炎症活动度评分(NAS)对CHB合并MAFLD患者进一步分析,比较各组病毒学(血清HBV DNA和HBsAg水平)特征差异。计量资料两组间比较采用Wilcoxon检验;多组间比较及进一步两两比较均采用Kruskal-Wallis H检验。计数资料两组间比较采用χ^(2)检验。结果CHB合并MAFLD患者中男性、高血压及2型糖尿病的比例,血生化指标甘油三酯、低密度脂蛋白胆固醇、载脂蛋白B、ALT、GGT、尿酸和空腹血糖均明显高于单纯CHB患者(P值均<0.05),而高密度脂蛋白胆固醇、载脂蛋白A1和HBV DNA水平均显著低于单纯CHB患者(P值均<0.05)。肝纤维化分期分层分析结果显示,单纯CHB组和CHB合并MAFLD组显著肝纤维化患者(S2~4)的HBV DNA水平均低于非显著肝纤维化患者(S0~1)(P值均<0.05);单纯CHB组显著肝纤维化患者(S2~4)的HBsAg水平明显低于非显著肝纤维化患者(S0~1)(P<0.05)。炎症活动度分层分析结果显示,CHB合并MAFLD组高炎症活动度患者(G3)的HBV DNA水平高于低炎症活动度患者(G1~2)(P<0.05);CHB合并MAFLD组低炎症活动度患者(G1~2)的HBsAg水平明显低于单纯CHB组低炎症活动度患者(P<0.05)。肝脂肪变性程度分层分析结果显示,HBV DNA水平随脂肪变性程度增加而逐渐降低,其中脂肪变性重度组HBV DNA水平明显低于轻度组(P<0.05),而HBsAg水平在不同肝脂肪变性程度组间无明显变化(P>0.05)。NAS分层分析结果显示,NAS≥4分组的HBV DNA和HBsAg水平均明显高于NAS<4分组(P值均<0.05)。结论CHB合并MAFLD患者具有明显的代谢指标和转氨酶水平异常,而病毒学指标在不同分层中表现出不同的特征。

Effectiveness and safety of tenofovir amibufenamide in chronic hepatitis B patients

This letter to the editor relates to the study entitled“Tenofovir amibufenamide vs tenofovir alafenamide for treating chronic hepatitis B:A real-world study”,which was recently published by Peng et al.Hepatitis B virus infection represents a significant health burden worldwide and can lead to cirrhosis and even liver cancer.The antiviral drugs currently used to treat patients with chronic hepatitis B infection still have many side effects,so it is crucial to identify safe and effective drugs to inhibit viral replication.

子宫颈单克隆浆细胞增生2例临床病理分析并文献复习

目的探讨2例宫颈单克隆浆细胞增生的临床病理特征、免疫组化特征、分子病理特征及预后。方法对2例宫颈单克隆浆细胞增生进行临床及影像分析、形态学分析、免疫组化染色和分子检测。结果病例1,23岁女性,宫颈黏膜上皮下弥漫浸润不同成熟度的浆细胞,可见多核细胞。病例2,37岁女性,宫颈间质内弥漫浸润具有非典型性的浆样分化的细胞。2例患者影像学均未发现宫颈占位,均显示轻链限制性表达和免疫球蛋白克隆性基因重排,均未进行其他特殊治疗,随访无明显不适。结论宫颈单克隆浆细胞增生是临床罕见的淋巴瘤样病变,常伴轻链限制性表达及免疫球蛋白克隆性基因重排,易被误诊为髓外浆细胞瘤而造成过度治疗。该病预后良好,切除局部病变后随访观察即可。

湖州地区妇女宫颈病变人乳头瘤病毒亚型感染情况分析

目的:研究湖州地区妇女宫颈病变患者人乳头瘤病毒(HPV)感染率及型别分布情况。方法:采用悬浮芯片技术对720例湖州地区妇女宫颈分泌物或脱落细胞进行18种高危型HPV和8种低危型HPV检测。结果:720例患者中HPV感染183例,占25.42%。单一感染135例,占18.75%;双重感染33例,占4.58%;三重以上感染15例,占2.08%。183例阳性标本主要为高危型HPV 16、58型,低危型HPV 11、6型。结论:湖州地区妇女宫颈病变患者HPV感染率为25.42%,并明确了HPV 16、HPV 58为该地区宫颈病变组织中HPV主要的流行亚型。

人乳头状瘤病毒感染及病毒载量与宫颈病变的相关性研究

目的:研究高危型人乳头状瘤病毒感染及病毒载量与宫颈病变的关系。方法:对774例研究对象采用第二代杂交捕获试验(HC-Ⅱ)进行宫颈脱落细胞的HPV-DNA定量检测。分析不同程度宫颈病变的HPV感染情况,并根据HPV病毒载量将所有检测对象分为四组,阴性(RLU/CO<1.0)、低载量(1.0≤RLU/CO<10)、中载量(10≤RLU/CO<100)、高载量(RLU/CO≥100),采用非条件多项式logistic回归分析病毒载量与宫颈病变级别的关系。结果:在检测的774例研究对象中,对照组、宫颈上皮内瘤变(cervical intraepithelial neo-plasia,CIN)Ⅰ、CINⅡ、CINⅢ和浸润性宫颈癌患者的HPV感染率分别为21.29%、82.35%、80.00%、90.16%和86.67%。对照组高危型HPV感染率明显低于CIN和浸润性宫颈癌患者,差异有统计学意义,P<0.01;HPV阳性者患CIN的风险是阴性者的24.96倍(95%CI:13.20～47.18),患浸润性宫颈癌的风险是HPV阴性者的24.03倍(95%CI:12.01～48.09)。在不同级别宫颈病变中,CINⅠ组的低病毒载量患者占11.67%,高载量占41.18%,OR值为23.84(95%CI:5.96～95.33),P<0.001;而在CINⅢ组中62.30%的患者呈高病毒载量,OR值达64.70(95%CI:25.98～161.20),P<0.001。结论:高危型HPV感染与CIN和浸润性宫颈癌的发生密切相关;宫颈高危型HPV病毒载量是影响宫颈病变严重程度的危险因素。

宫颈液基细胞学涂片假阴性原因分析

目的回顾宫颈涂片中假阴性病例,分析产生假阴性的原因。方法利用TCT技术检测6 850例宫颈涂片,其中细胞学阴性而活检阳性63例,分别记录其细胞量、有无宫颈柱状细胞/化生细胞涂片、是否血涂片、病灶与宫颈管距离及其组织病理结果。结果原细胞学诊断阴性复查为阳性、缺乏宫颈柱状细胞和化生细胞涂片、细胞量<30%、有血涂片、病灶与宫颈管距离>1 cm者,在假阴性病例中分别占7.93%、19.04%、14.28%、20.6%、46.03%。病灶与颈管距离>1 cm且病变合并尖锐湿疣假阴性者与病灶离颈管距离<1 cm且病变合并扁平湿疣者比较,差异有显著性(P<0.05)。结论获取满意的宫颈细胞样本、改进标本处理、加强细胞学医师继续教育和提高自身诊断水平是降低宫颈涂片假阴性的有效方法。临床医师对症状体征可疑但细胞学阴性的病例采取阴道镜下多点活检可减少假阴性的发生。

急性视网膜坏死发病机制的研究进展

急性视网膜坏死（ARN）是一种少见的病毒感染性疾病,其致病病毒主要是疱疹病毒,易引起视网膜脱离等并发症,故视力预后较差.ARN的发生和发展主要为感染与抗感染的过程,包括病毒入侵、播散、潜伏活化及机体免疫应答等方面.病毒进入宿主细胞是病毒表面蛋白与宿主细胞表面受体结合的过程,病毒感染后可潜伏于眼部相关的神经组织及眼内组织中.研究表明,病毒感染后可活化机体的免疫系统,诱发免疫细胞吞噬病毒、活化其他免疫细胞、产生细胞因子并介导炎症反应等,从而起到清除病毒、控制感染的目的,这些免疫细胞及细胞因子相互作用,共同参与ARN的发病过程.就病毒入侵、播散及机体免疫等与ARN发生和发展的关系进行综述.

宫颈不同形态尖锐湿疣与HPV亚型的关系

目的 探讨宫颈不同形态尖锐湿疣与人乳头瘤病毒 (HPV )亚型的关系。方法 对 86例宫颈尖锐湿疣采用聚合酶链反应 (PCR)分析HPV亚型 ,超微病理观察宫颈尖锐湿疣的病理变化。结果 扁平形宫颈尖锐湿疣 ,HPV 6 /11感染率 ( 81.2 % )明显高于HPV 16 /18感染率 ( 8.7% ) (P <0 .0 1) ;乳头形宫颈尖锐湿疣 ,HPV 16 /18感染率 ( 6 4.7% )明显高于HPV 6 /11感染率 ( 17.6 % ) (P <0 .0 1)。病理变化 :扁平形宫颈尖锐湿疣主要为挖空细胞 ,分化程度较高 ;而乳头形宫颈尖锐湿疣主要为细胞核的病理改变 ,其分化程度较低。在具有挖空细胞的宫颈尖锐湿疣中 ,HPV 6 /11感染率( 83 .8% )明显高于HPV 16 /18感染率 ( 7.4% ) (P <0 .0 1) ,以细胞核病理改变为主的宫颈尖锐湿疣中 ,HPV16 /18感染率( 6 6 .7% )明显高于HPV 6 /11感染率 ( 11.1% ) (P <0 .0 1)。结论 宫颈尖锐湿疣的形态与HPV亚型的感染有关。

宫颈上皮内瘤样病变锥切术后HPV动态检测价值的探讨

目的:探讨宫颈上皮内瘤样病变(cervical intraepithelial neoplasm,CIN)患者在LEEP锥切术后其宫颈中HPV消失情况。方法:对60例阴道镜下确诊为CIN的患者行HPV检测,检测方法采用凯普TM导流杂交对HPV进行分型检测,LEEP术后3、6和12个月再次检测,同时行液基薄层细胞(liquied based cyctology test,TCT)检测。结果:术前CINⅠ、CINⅡ、CINⅢ的感染率分别为23.10%、85.70%和96.20%,高级别病变感染率与低级别病变感染率差异有统计学意义,P<0.05。术后清除率分别为100%、88.89%和80.00%,差异无统计学意义,P>0.05;HPV持续阳性提示病变残留或复发;HPV感染与标本切缘阳性率无关。结论:LEEP治疗CIN后HPV的清除率较高,HPV检测可作为CIN术后随访的有效手段。

HPV检测和液基细胞学检查在宫颈病变筛查中的应用

目的通过与病理组织学检查结果比较,评价高危型人乳头瘤病毒(HR-HPV)检测和液基细胞学检查在宫颈病变筛查中的应用价值。方法对2004年12月～2006年12月在解放军总医院行HR-HPV和液基细胞学检查及电子阴道镜下宫颈活组织病理检查的690例患者的资料进行回顾性分析。结果690例患者中液基细胞学与病理组织学检查的符合率为:低度鳞状上皮内病变(LSIL)22.34%(42/188),高度鳞状上皮内病变(HSIL)58.33%(56/96),宫颈癌100%(16/16)。细胞学结果示良性细胞改变75例;不典型鳞状细胞(ASC)、LSIL、HSIL和宫颈癌者分别为315、188、96、16例,其HR-HPV阳性率分别为53.96%(170/315)、77.12%(134/188)、80.21%(77/96)和100%(16/16)。经阴道镜下多点活检病理组织学诊断为炎症、上皮内瘤变Ⅰ级和(或)湿疣(CINⅠ/HPV)、CINⅡ/CINⅢ、宫颈浸润癌者分别为425、81、157和27例,其HR-HPV阳性率分别为43.29%(184/425)、74.93%(60/81)、91.72%(144/157)和92.5%(25/27)。此外,413例HR-HPV阳性者中,病理学≥CINⅠ/HPV者占55.45%(229/413);277例HR-HPV阴性者中,病理学为炎症者占87.01%(241/277),≥CINⅠ/HPV者占12.99%(36/277),而36例≥CINⅠ/HPV者中CINⅡ/CINⅢ和宫颈浸润癌仅占5.42%(15/277)。315例ASC中,HR-HPV阳性者170例,病理学≥CINⅠ/HPV占41.76%(71/170),其中CINⅡ/CINⅢ和宫颈浸润癌占69.01%(49/71);HR-HPV阴性145例,病理学≥CINⅡ/CINⅢ者仅占4.83%(7/145),炎症占90.34%(131/145)。结论HR-HPV和液基细胞学检查是筛查宫颈病变的有效方法,二者结合有利于宫颈病变的分流管理,提高宫颈癌及癌前病变的检出率。

六安地区手足口病患儿肠道病毒分离鉴定与临床表现

目的对六安地区手足口病流行区患儿标本进行病毒分离与鉴定,为进一步预防和控制该病流行奠定基础。方法采集手足口病患者咽拭子和疱疹液标本,进行病毒分离、中和实验和逆转录-聚合酶链反应(RT-PCR)特异性扩增进行鉴定,同时对肠道病毒71型(EV71)抗原决定簇部位VP1区进行核苷酸序列测定与分析。结果14份咽拭子和8份疱疹液标本中分离得到6株病毒,经中和实验、RT-PCR及VP1片段检测与测序证实为EV71型,与BrCr-ts株、台湾分离株、深圳分离株一致性分别为98%、84%和83%。结论该流行区2008年爆发的手足口病病原体为EV71型。

子宫颈锥切术治疗子宫颈上皮内瘤变和Ⅰa_1期子宫颈癌99例分析

目的：探讨子宫颈锥切术在子宫颈上皮内瘤变（cervical intraepithelial neoplasia，CIN）及Ⅰa1期子宫颈癌诊治中的价值及其并发症的预防。方法：对99例CIN2~3级及Ⅰa1期子宫颈癌患者采用冷刀或电刀锥形切除子宫颈的治疗方法，分析手术治疗效果、手术并发症及其相关因素。结果：CIN2级患者锥切术后有20%（6/30）升为CIN3级。锥切术后发现CIN3级合并早期浸润癌者占8.96%，锥切术前后病理诊断完全符合率为72.73%。单纯行子宫颈锥切术的92例患者随访至2007年1月30日无一例复发。术后早期出血发生率18.48%，晚期出血发生率9.78%，感染发生率4.34%。术后成功妊娠分娩率44.0%。结论：子宫颈锥切术后病理诊断与术前子宫颈多点活检病理诊断仍有不同；对子宫颈病变范围较大，阴道镜诊断不满意的CIN2级患者行子宫颈锥切术，既可进一步明确诊断，又可彻底切除病灶。对年轻、要求保留生育功能的CIN 3级患者行子宫颈锥切术是安全、有效的治疗方法，其并发症通过提高手术技巧可以预防。

液基薄层细胞学检测在宫颈疾病中的应用

目的评价液基薄层细胞学检测(LCT)原理及其在宫颈疾病中的应用价值。方法对进行LCT检查的907例临床资料展开回顾性分析。结果907张涂片中正常细胞涂片727张,鳞状上皮异常164张,腺上皮异常16张。同时检出形态符合念珠菌属感染者5例,滴虫1例,放线菌1例,细菌过度增多者71例,类湿疣病变40例,湿疣病变13例。结论LCT技术在阴道镜宫颈疾病的诊断中具有重要意义。

宫颈病变中HPV感染与IL-2、IL-4表达的关系

目的:探讨宫颈病变局部白细胞介素(IL)-2、IL-4的表达与宫颈人乳头状瘤病毒(HPV)感染的关系。方法:收集宫颈活检组织92例,其中宫颈浸润性鳞状细胞癌(鳞癌)组织38例,宫颈上皮内瘤样病变(CIN)组织22例,宫颈正常或炎症组织32例。采用原位杂交法检测HPV16/18DNA、IL-2mRNA、IL-4mRNA在样本中的表达,按HPV16/18表达阳性或阴性对IL-2、IL-4在样本中的表达进行分层分析。结果:IL-2、IL-4阳性表达率在HPV16/18阴性表达的各组间其差异均无统计学意义(P>0.05)。在HPV16/18阳性表达的正常或炎症组、CIN组、鳞癌组中IL-2阳性表达率分别为0.0%、50.0%、5.9%。IL-4阳性表达率分别为0.0%、75.0%、88.2%,其差异均有统计学意义(P<0.05或P<0.01)。结论:随着病变严重程度的增加,感染HPV的宫颈组织中IL-2表达先增加后减少,IL-4表达增加。