HPV感染及其基因型与宫颈病变患者病灶微环境Th1/Th2平衡及疾病进展的关系  

Relationship between HPV infection and its genotypes and Th1/Th2 balance and disease progression in lesion micro-environment of patients with cervical lesions

作　　者：沈丽 薛平莉 朱燕娜 SHEN Li;XUE Ping-li;ZHU Yan-na(Changzhou Second People's Hospital Affiliated to Nanjing Medical University,Changzhou,Jiangsu 213000,China;不详)

机构地区：[1]南京医科大学附属常州第二人民医院妇科,江苏常州213000 [2]常州市妇幼保健院妇科,江苏常州213000

出　　处：《中华医院感染学杂志》2022年第16期2510-2514,共5页Chinese Journal of Nosocomiology

基　　金：江苏省自然科学基金资助项目(2019568)。

摘　　要：目的 研究人乳头瘤病毒(HPV)感染及基因分型与宫颈病变病灶微环境辅助性T细胞1(Th1)/辅助性T细胞2(Th2)平衡及疾病进展的关系。方法 收集2018年6月-2020年6月于南京医科大学附属常州第二人民医院接受治疗的宫颈病变患者90例;根据是否感染HPV将患者分为未感染组19例和感染组71例,检测两组患者病灶微环境中Th1型和Th2型细胞因子水平;检测感染组HPV感染基因分型;比较不同分型病毒感染患者病灶微环境中Th1和Th2型细胞因子水平和疾病进展情况。结果 未感染组宫颈及阴道灌洗液中干扰素γ(IFN-γ)、肿瘤坏死因子α(TNF-α)和白细胞介素-2(IL-2)水平高于感染组(P<0.05),白细胞介素-4(IL-4)、白细胞介素-10(IL-10)水平低于感染组(P<0.05)。未感染组CINⅠ级和CINⅡ级患者分别占36.84%和57.89%,高于感染组12.68%和32.39%(P<0.05);CINⅢ级患者和宫颈癌患者分别占0和5.26%,低于感染组23.94%和30.99%(P<0.05)。HPV6型和HPV11型感染患者宫颈及阴道灌洗液中IFN-γ、TNF-α、IL-2水平以及CINⅠ级和CINⅡ级患者比例高于HPV16型和HPV18型感染患者(P<0.05),宫颈及阴道灌洗液中IL-4、IL-10水平及CINⅢ级和宫颈癌患者比例均低于HPV16型和HPV18型感染患者(P<0.05)。结论 高危型HPV基因感染会促进Th1/Th2漂移,并促进宫颈病变的进展。OBJECTIVE To study the relationship between human papilloma virus(HPV) infection, its genotypes and balance of T helper cell 1(Th1)/T helper cell 2(Th2) and disease progression in lesion micro-environment of patients with cervical lesions. METHODS A total of 90 patients with cervical lesions treated in Changzhou Second People’s Hospital affiliated to Nanjing Medical University from Jun 2018 and Jun 2020 were enrolled. According to whether HPV infection occurred, they were divided into the non-infection group(19 cases) and infection group(71 cases). The levels of Th1 and Th2 cytokines in lesion micro-environment of both groups were detected. And disease progression in both groups was analyzed. The genotypes of HPV infection in the infection group were detected. The levels of Th1 and Th2 cytokines in lesion micro-environment and disease progression among patients with different types of virus infection were compared. RESULTS The levels of interferon γ(INF-γ), tumor necrosis factor α(TNF-α) and interleukin 2(IL-2) in cervical and vaginal lavage fluid of the non-infection group were significantly higher than those of the infection group(P<0.05), while levels of interleukin 4(IL-4) and interleukin 10(IL-10) were significantly lower than those of the infection group(P<0.05). The proportions of patients at grade CIN I and CIN Ⅱ in the non-infection group were 36.84% and 57.89%, respectively, which were significantly higher than those in the infection group(12.68%, 32.39%)(P<0.05);while proportions of patients at grade CIN Ⅲ and with cervical cancer in the non-infection group were 0 and 5.26%, respectively, which were significantly lower than those in the infection group(23.94%, 32.99%)(P<0.05). The levels of INF-γ, TNF-α and IL-2 in cervical and vaginal lavage fluid and proportions of cases at grades CIN I and CIN Ⅱ in patients with HPV6 and HPV11 infection were significantly higher than those with HPV16 and HPV18 infection(P<0.05), while levels of IL-4 and IL-10 in cervical and vaginal lavage fluid and pr

关 键 词：人乳头瘤病毒 基因分型 宫颈病变 阴道灌洗液 炎症细胞因子 疾病进展 

分 类 号：R711.74[医药卫生—妇产科学]