高危型人乳头瘤病毒持续感染宫颈局部免疫状态的研究  

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

作　　者：张玲[1,2] 宋华林[1] 曲芃芃[2] 

机构地区：[1]天津医科大学,300070 [2]天津市中心妇产科医院

出　　处：《天津医药》2016年第11期1363-1366,共4页Tianjin Medical Journal

基　　金：天津市卫生行业重点攻关项目(15KG140);天津市科技计划项目(09ZCZDSF03900)

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。Objective To explore the changes of cervical local cytokines Th1, Th2 and Th17 in the process of high riskhuman papillomavirus(HR- HPV) persistent infection and their relationship with cervical lesions. Methods A total ofseventy married women who were referred to colposcopy clinic in our hospital from November 2015 to January 2016 wereincluded in this research. According to the HR-HPV infection status and pathological results, patients were divided into fourgroups: the cleared group(n=16), no squamous intraepithelial lesion group(NSIL, n=18), low-grade squamous intraepitheliallesion group(LSIL, n=18) and high-grade squamous intraepithelial lesion group(HSIL, n=18). The NSIL group, LSIL groupand HSIL group were merged into the persistent infection group, while the LSIL group and HSIL group were amalgamatedinto the diseased group. The concentrations of interleukin-2(IL-2), IL-4, IL-6, IL-10, IL-17 A, tumor necrosis factor(TNF)and γ- interferon(IFN- γ) in vaginal douche were measured by BD cytometric bead array. The changes of the abovecytokines and the relationship between Th2/Th1 and Th2/Th17 were analyzed according to the severity, persistent status anddisease status. Results The levels of IL-6 increased significantly with the severity of disease(P < 0.05), while the levels ofIL-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 thecleared group, the level of IL-6 increased and IL-2 decreased in persistent infection group, which showed a same results inthe 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 relatedwith the cervical local immune microenvironment.

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 

分 类 号：R711.74[医药卫生—妇产科学] R737.33[医药卫生—临床医学]