天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (11): 1363-1366.doi: 10.11958/20160549

• 临床研究 • 上一篇    下一篇

高危型人乳头瘤病毒持续感染宫颈局部免疫状态的研究

张玲 1， 2， 宋华林 1， 曲芃芃 2△   

  1. 1 天津医科大学 （邮编 300070）； 2 天津市中心妇产科医院
  • 收稿日期:2016-06-13 修回日期:2016-09-14 出版日期:2016-11-15 发布日期:2016-11-15
  • 通讯作者: △Corresponding Author E-mail: Qu.pengpeng@hotmail.com E-mail:qu.pengpeng@hotmail.com
  • 作者简介:张玲 （1990）， 女， 硕士研究生在读， 主要从事妇科肿瘤研究
  • 基金资助:
    天津市卫生行业重点攻关项目 （15KG140）； 天津市科技计划项目 （09ZCZDSF03900）

Study on local immune status in women with cervical persistent infection of high-risk human papillomavirus

ZHANG Ling1,2, SONG Hualin1, QU Pengpeng2△   

  1. 1 Tianjin Medical University, Tianjin 300070, China; 2 Tianjin Central Hospital of Gynecology and Obstetrics
  • Received:2016-06-13 Revised:2016-09-14 Published:2016-11-15 Online:2016-11-15
  • Contact: △通讯作者 E-mail： Qu.pengpeng@hotmail.com E-mail:qu.pengpeng@hotmail.com

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摘要： 目的 探讨高危型人乳头瘤病毒 （HR-HPV） 持续感染过程中宫颈局部 Th1、 Th2、 Th17 相关细胞因子的变 化及其与宫颈病变程度之间的关系。方法 选取 2015 年 11 月—2016 年 1 月我院阴道镜门诊有 HR-HPV 感染史 的已婚妇女 70 例， 按照感染情况及病理结果分为 4 组： 转阴组 （16 例）， 无宫颈病变组 （NSIL 组， 18 例）， 低级别上皮 内病变组（LSIL 组， 18 例）， 高级别上皮内病变组（HSIL 组， 18 例）。其中 NSIL 组、 LSIL 组、 HSIL 组合并称为持续感 染组， LSIL 组、 HSIL 组合并称为病变组。用流式 BD-CBA 法检测各组阴道灌洗液中白细胞介素 （IL） -2、 IL-4、 IL-6、 IL-10、 肿瘤坏死因子 （TNF）、 γ 干扰素 （IFN-γ） 及 IL-17A 的水平。根据病变程度、 是否存在持续感染、 持续感染状态 下有无病变情况比较各组细胞因子的变化， 同时分析 Th2/Th1、 Th2/Th17 变化。结果 随着病变程度的加重， IL-6 的水平逐渐升高（P＜0.05）， LSIL 组、 HSIL 组 IL-2 水平低于转阴组和 NSIL 组（P＜0.05）， 其他细胞因子水平差异无 统计学意义 （P > 0.05）。持续感染组与转阴组比较， 病变组与 NSIL 组比较， 均发现 IL-6 升高， IL-2 降低。病变程度 越严重， Th2/Th1、 Th2/Th17 越高。结论 宫颈 HR-HPV 持续感染及宫颈上皮内病变的发生与宫颈局部免疫微环境 密切相关。

关键词: 人乳头瘤病毒, 宫颈肿瘤, 宫颈上皮内瘤样病变, Th1 细胞, Th2 细胞, 细胞因子类, 免疫微环境

Abstract: Objective To explore the changes of cervical local cytokines Th1, Th2 and Th17 in the process of high risk human papillomavirus (HR- HPV) persistent infection and their relationship with cervical lesions. Methods A total of seventy married women who were referred to colposcopy clinic in our hospital from November 2015 to January 2016 were included in this research. According to the HR-HPV infection status and pathological results, patients were divided into four groups: the cleared group (n=16), no squamous intraepithelial lesion group (NSIL, n=18), low-grade squamous intraepithelial lesion group (LSIL, n=18) and high-grade squamous intraepithelial lesion group (HSIL, n=18). The NSIL group, LSIL group and HSIL group were merged into the persistent infection group, while the LSIL group and HSIL group were amalgamated into the diseased group. The concentrations of interleukin-2 (IL-2), IL-4, IL-6, IL-10, IL-17A, tumor necrosis factor (TNF) and γ- interferon (IFN- γ) in vaginal douche were measured by BD cytometric bead array. The changes of the above cytokines and the relationship between Th2/Th1 and Th2/Th17 were analyzed according to the severity, persistent status and disease status. Results The levels of IL-6 increased significantly with the severity of disease (P < 0.05), while the levels of IL-2 were decreased significantly in LSIL group and HSIL group compared with those of the cleared group and NSIL group (P < 0.05). The other cytokines showed no significant differences between the four groups (P > 0.05). Compared with the cleared group, the level of IL-6 increased and IL-2 decreased in persistent infection group, which showed a same results in the diseased group compared with NSIL group. The more serious of the diseases, the higher levels in Th2/Th1 and Th2/Th17. Conclusion The persistence of HR-HPV infection and the occurrence of cervical intraepithelial lesion are closely related with the cervical local immune microenvironment.

Key words: human papillomavirus, uterine cervical neoplasms, cervical intraepithelial neoplasia, Th1 cells, Th2 cells, cytokines, immune microenvironment