宫颈病变患者血清白细胞介素2、白细胞介素4、干扰素γ水平与高危型HPV感染相关性研究  

Correlation between serum levels of IL-2,IL-4,IFN-γand high-risk HPV infection in patients with cervical lesions

作　　者：曹泰华 刘双爱 赵祖国 CAO Taihua;LIU Shuang’ai;ZHAO Zuguo(Department of Microbiology and Immunology,Guangdong Medical University,Dongguan 523808,China)

机构地区：[1]广东医科大学微生物学与免疫学教研室,广东东莞523808 [2]东莞市妇幼保健院,广东东莞523000

出　　处：《陕西医学杂志》2023年第11期1546-1549,1553,共5页Shaanxi Medical Journal

基　　金：广东省自然科学基金资助项目(2019MS08204)。

摘　　要：目的:探讨宫颈病变患者血清白细胞介素2(IL-2)、IL-4、干扰素γ(IFN-γ)水平与高危型人乳头瘤病毒(HR-HPV)感染的相关性。方法:选择126例HR-HPV阳性并经病理确诊上皮类瘤变(CIN)或宫颈癌患者为观察组,另选同期42例正常体检女性为对照组,检测两组患者阴道微环境[乳酸杆菌、需氧菌性阴道炎(AV)、细菌性阴道炎(BV)、外阴阴道假丝酵母菌病(VVC)、滴虫性阴道炎(TV)]情况,酶联免疫吸附法(ELISA)检测两组血清IL-2、IL-4、IFN-γ水平,分析IL-2、IL-4、IFN-γ与HR-HPV感染的关系,并进行HR-HPV感染的多因素Logistic回归分析。结果:CINⅠ级HR-HPV负荷量>1000患者比例低于宫颈癌、CINⅡ级、CINⅢ级患者,HR-HPV负荷量1~100患者比例大于宫颈癌、CINⅡ级、CINⅢ级患者,差异有统计学意义(均P<0.05)。宫颈癌患者乳酸杆菌分级、pH值>4.5、BV、TV、VVC比例高于CINⅠ级患者(均P<0.05)。BV、TV、VVC、乳酸杆菌为HR-HPV感染的独立危险因素(均P<0.05)。对照组血清IL-2、IFN-γ水平高于CINⅠ级、CINⅡ级、CINⅢ级、宫颈癌患者,IL-4低于CINⅠ级、CINⅡ级、CINⅢ级、宫颈癌患者(均P<0.05)。血清IL-2、IFN-γ与HR-HPV感染呈负相关,IL-4与HR-HPV感染呈正相关(均P<0.01)。结论:HR-HPV感染患者阴道微环境改变,血清IL-2、IFN-γ水平下降,IL-4升高,HR-HPV感染与血清IL-2、IL-4、IFN-γ水平有关,通过检测IL-2、IL-4、IFN-γ水平和阴道局部微环境可能判断CIN的进展情况,并筛选高危人群并密切监测,对减少宫颈癌的发生可能具有重要意义。Objective:To investigate the correlation between serum levels of interleukin-2(IL-2),IL-4,interferonγ(IFN-γ)and human papillomavirus(HR-HPV)infection in patients with cervical lesions.Methods:126 HR-HPV-positive patients with epithelial neoplasia(CIN)or cervical cancer confirmed by pathology were selected as the observation group,and 42 normal female patients were selected as the control group.The vaginal microenvironment(Lactobacillus,aerobic vaginitis[AV],bacterial vaginitis[BV],vulvovaginal pseudomonas[VVC]and trichomoniasis[TV])of the two groups were detected,and serum levels of IL-2,IL-4 and IFN-γwere detected by enzyme-linked immunosorbent assay(ELISA).The relationship between IL-2,IL-4,IFN-γand hr-HPV infection was analyzed,and multivariate Logistic regression analysis of HR-HPV infection was performed.Results:The proportion of patients with HR-HPV load>1000 in CINⅠwas lower than that in cervical cancer,CINⅡand CINⅢ,while the proportion of patients with HR-HPV load of 1 to 100 was higher than that in cervical cancer,CINⅡand CINⅢ,with statistical significance(all P<0.05).The lactobacillus grade,pH>4.5,BV,TV,VVC ratio of cervical cancer patients were higher than those of CINⅠpatients(all P<0.05).BV,TV,VVC and lactobacillus were independent risk factors for HR-HPV infection(all P<0.05).The serum levels of IL-2 and IFN-γin control group were higher than those in CINⅠ,CINⅡ,CINⅢand cervical cancer patients,and IL-4 was lower than that in CINⅠ,CINⅡ,CINⅢand cervical cancer patients(all P<0.05).Serum IL-2 and IFN-γwere negatively correlated with HR-HPV infection,while IL-4 was positively correlated with HR-HPV infection(all P<0.01).Conclusion:In patients with HR-HPV infection,vaginal microenvironment changes,serum IL-2 and IFN-γlevels decrease,and IL-4 levels increase.HR-HPV infection is related to serum IL-2,IL-4 and IFN-γlevels,and detection of IL-2,IL-4 and IFN-γlevels and local vaginal microenvironment may determine the progression of CIN.Screening and close monitoring of high-r

关 键 词：高危型人乳头瘤病毒 白细胞介素2 白细胞介素4 干扰素Γ 阴道微环境 宫颈病变 

分 类 号：R711.32[医药卫生—妇产科学]