男性尖锐湿疣合并HIV患者的全血淋巴细胞亚群和尖锐湿疣组织的病理特点  

Pathological characteristics of whole blood lymphocyte subsets and condyloma acuminatum tissue in male patients with condyloma acuminata and HIV

作　　者：陈香梅 马志园[1] 袁柳凤 孙磊[1] 王鹏[1] CHEN Xiangmei;MA Zhiyuan;YUAN Liufeng;SUN Lei;WANG Peng(Department of Pathology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015;Department of Dermatology,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China)

机构地区：[1]首都医科大学附属北京地坛医院病理科,北京100015 [2]首都医科大学附属北京地坛医院皮肤科,北京100015

出　　处：《临床与病理杂志》2022年第3期601-608,共8页Journal of Clinical and Pathological Research

基　　金：北京市医院管理中心“青苗”计划专项基金(QML20201803)。

摘　　要：目的:探究男性尖锐湿疣(condyloma acuminatum,CA)合并人类免疫缺陷病毒(humanimmunodeficiency virus,HIV)患者全血辅助性T淋巴细胞亚群与CA组织Ki-67、p16、血管内皮生长因子(vascular endothelial growth factor,VEGF)、CD34表达的相关性及其临床意义。方法:回顾分析2018年10月至2020年10月85例男性CA患者的临床病理资料。根据是否合并HIV感染将其分为CA组(36例)与CA合并HIV组(49例)。分析两组HPV的感染情况和全血辅助性T淋巴细胞亚群(淋巴细胞、T淋巴细胞、CD4^(+)T淋巴细胞及CD8^(+)T淋巴细胞)计数的差异;HE染色观察CA组织的病理形态特点;免疫组织化学染色检测CA组织Ki-67、p16、VEGF、CD34的表达,分析两组Ki-67、p16、VEGF、CD34的表达差异;采用Spearman秩相关分析研究全血辅助性T淋巴细胞亚群与HPV感染、Ki-67、p16、VEGF、CD34的相关性;应用logistic逐步回归分析探讨CA合并HIV的影响因素。结果:CA合并HIV组CD8^(+)T淋巴细胞计数、Ki-67增殖指数、p16表达、VEGF表达、CD34微血管密度均高于CA组(分别P<0.001、P=0.009、P<0.001、P<0.001、P<0.001),CA合并HIV组CD4^(+)T淋巴细胞计数低于CA组(P<0.001),两组间HPV感染、淋巴细胞计数、T淋巴细胞计数的差异均无统计学意义(分别P=0.135、P=0.862、P=0.876)。淋巴细胞计数和Ki-67增殖指数呈正相关(r_(s)=0.257,P=0.018),CD4^(+)T淋巴细胞计数与p16表达、VEGF表达呈负相关(r_(s)=−0.232,P=0.033;r_(s)=−0.252,P=0.020),CD8^(+)T淋巴细胞计数与HPV感染、Ki-67增殖指数、p16表达、VEGF表达呈正相关(r_(s)=0.220,P=0.043;r_(s)=0.346,P=0.001;r_(s)=0.350,P=0.001和r_(s)=0.363,P=0.001),其他指标间不存在相关性。Logistic回归分析显示CD4^(+)T淋巴细胞计数、p16表达、VEGF表达、CD34微血管密度是CA合并HIV的独立危险因素。结论:在男性CA合并HIV患者中,血清CD4^(+)T淋巴细胞计数降低,CA组织细胞增殖活跃及血管生成增多,可作为CA诊断及预后不良的Objective:To explore the correlation and clinical significance of whole blood lymphocyte subsets and the expression of Ki-67,p16,VEGF and CD34 in male condyloma acuminatum(CA)patients with human immunodeficiency virus(HIV).Methods:The clinicopathological data of 85 male patients with CA from October 2018 to October 2020 were retrospectively analyzed.They were divided into a CA group(36 cases)and a CA combined with HIV group(49 cases)according to whether they were infected with HIV.The infection of HPV and the count of helper T lymphocyte subsets(lymphocyte,T lymphocyte,CD4^(+)T lymphocyte and CD8^(+)T lymphocyte)in the whole blood of the 2 groups were analyzed;the pathological features of CA tissues were observed by HE staining;the expression of Ki-67,p16,VEGF and CD34 in CA tissues were detected by immunohistochemical staining;the expression differences of Ki-67,p16,VEGF and CD34 between the 2 groups were analyzed.Spearman rank-correlation analysis was used to analyze the correlation between the whole blood helper T lymphocyte subsets and HPV infection,Ki-67,p16,VEGF,CD34;logistic stepwise regression analysis was used to explore the influencing factors of CA complicated with HIV.Results:The CD8^(+)T lymphocyte count,Ki-67 proliferation index,p16 expression,VEGF expression and CD34 microvessel density of the CA combined with HIV were higher than those of the CA group(P<0.001,P=0.009,P<0.001,P<0.001,P<0.001,respectively).The CD4^(+)T lymphocyte count of the CA combined with HIV was lower than that of the CA group(P<0.001).There was no significant difference in HPV infection,lymphocyte count and T lymphocyte count between the 2 groups(P=0.135,0.862 and 0.876).There was a positive correlation between lymphocyte count and Ki-67 proliferation index(r_(s)=0.257,P=0.018),a negative correlation between CD4^(+)T lymphocyte count,p16 expression and VEGF expression(r_(s)=−0.232,P=0.033 and r_(s)=−0.252,P=0.020),and a positive correlation between CD8^(+)T lymphocyte count and HPV infection,Ki-67 proliferation index,p16 e

关 键 词：尖锐湿疣 人类免疫缺陷病毒 辅助性T淋巴细胞亚群 Ki-67 p16 血管内皮生长因子 

分 类 号：R752.53[医药卫生—皮肤病学与性病学] R512.91[医药卫生—临床医学]