宫颈高危型HPV感染者外周血T、B淋巴细胞及NK细胞变化分析

摘要

目的 研究宫颈高危型HPV感染者外周血T、B淋巴细胞及NK细胞的变化及临床意义.方法 收集高危型HPV-DNA阳性133例为病例组,其中亚临床感染(SPI)31例,CIN Ⅰ 24例、CIN Ⅱ28例、CIN Ⅲ26例及宫颈鳞癌(SCC)24例,同时选取健康者30例为对照,用流式细胞仪检测各组外周血淋巴细胞百分比,分析各组之间差异.结果 HPV16/18型与其他型别感染各细胞变化趋势一致:对照组、SPI及CIN Ⅰ三组间各细胞变化无统计学意义(P＞0.05);CINⅡ与CINⅢ组间比较差异无统计学意义(P＞0.05);与对照组及亚临床组比较,CIN Ⅱ、CIN Ⅲ及SCC组CD4+、CD16+56+降低,CD8+升高,CD4+/CD8+降低,差异均有统计学意义(P＜0.05),且随着病理分期的进展,CD4+、CD16+56+依次呈下降趋势,而CD8+逐渐上升,CD4+/CD8+逐渐降低,甚至SCC组的CD4+/CD8+显著低于CIN Ⅰ组,并出现倒置现象,差异均有统计学意义(P＜0.05);CD3+、CD19+在各组间差异均无统计学意义(P＞0.05).结论 宫颈高危型HPV感染伴宫颈病变及宫颈鳞癌患者体内存在不同程度的细胞免疫与固有免疫降低,检测各类淋巴细胞亚群的变化可用于进一步研究宫颈高危型HPV感染的免疫机制,为临床高危型HPV感染的免疫干预及预后提供客观依据.%Objective To analyse the changes of T,B lymphocyte and NK cells and its clinical significance in peripheral blood with high-risk HPV infection in the cervix.Methods 133 cases with HPV-DNA positive were collected including 31 patients of subclinical infection(SPI),24 cases of CIN Ⅰ,28cases of CIN Ⅱ 、26 cases of CINⅢ and 24 cases of Squamous cell carcinoma(SCC).Meanwhile,30 cases of healthy people were selected as control group.Detecting the level of patients' peripheral blood lymphocyte by flow cytometry and the differences were analysed among the groups.Results The trend of the changes for high risk HPV infection in other types was consistent with HPV16/18:there was no significant difference among the three groups of control,SPI and CINI (P＞0.05).Meanwhile,there was no significant difference in group of CIN Ⅱ and CIN Ⅲ (P＞0.05).Compared with subclinical infection group and control group,CD4+,CD16+ 56+ in groups of CIN Ⅱ,CIN Ⅲ and SCC were decreased,CD8+ were increased,the ratio of CD4+/CD8+ decreased,the differences were significant (P＜0.05).With the progress of the pathological staging,the level of CD4+,CD16+ 56+ were decreased gradually,CD8+ were increased gradually,the ratio of CD4+/CD8+ in group of SCC was significant lower than group of CIN Ⅰ,and the inversion was observed,the difference was statistically significant (P＜ 0.05),while there was no significant differences in CD3+ and CD19+ among the four groups (P＞0.05).Conclusion Cell-medicated immunity and innate immunity decreased in patients with high-risk HPV infection for high grade cervical lesions and squamous cell carcinoma of the cervix,detecting the changes of all kinds of lymphocyte subsets can be used to further explore the immune mechanism of high-risk HPV infection of cervix,and provide objective basis for the immune intervention and prognosis of clinical high-risk HPV infection.