体液免疫水平与宫颈上皮内病变及早期宫颈癌的相关性
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摘要
目的:研究探讨宫颈上皮内病变(CIN)及早期宫颈癌与患者全身及局部体液免疫功能的变化之间的关系。方法:检测宫颈上皮内病变103例(包括LSIL组20例及HSIL组83例),Ⅰ期宫颈癌60例及HPV阴性且宫颈活检正常者25例(阴性对照组)的外周血免疫球蛋白IgA、IgG、IgM和补体C3、C4,以及阴道灌洗液中的免疫细胞因子IL-2和IL-10。结果:(1)外周血免疫球蛋白检测结果:免疫球蛋白IgA、IgG、IgM和补体C3、C4在阴性对照组、LSIL组、HSIL组和早期宫颈癌组四组间的差异均无统计学意义(P>0. 05),但IgA似有随着宫颈病变进展而升高的趋势。(2)阴道灌洗液中免疫细胞因子检测结果:IL-2在阴性对照组、LSIL组、HSIL组和早期宫颈癌组中的表达逐渐降低,差异有统计学意义(P<0. 001);而IL-10的表达逐渐升高,差异亦有统计学意义(P<0. 05)。结论:CIN及早期宫颈癌作为宫颈局部病变,除对与黏膜免疫相关的IgA可能有一定影响外,对其他的全身体液免疫指标影响不大。但宫颈病变可导致阴道的局部免疫降低,促进病变发展。因此,阴道灌洗液中IL-2及IL-10的变化可为宫颈病变进展的预警指标之一。
Objective:To study the relationship between cervical intraepithelial lesion(CIN) and early cervical cancer and systemic and local humoral immunity of the patients. Methods: Peripheral blood immunoglobulin IgA,IgG,IgM and C3 and C4,and vaginal lavage the immune cytokine interleukin-2( IL-2) and interleukin 10( IL-10) were detected by 103 cases of cervical intraepithelial lesions( including 20 cases of LSIL and 83 cases of HSIL),60 cases of stage Ⅰ cervical cancer,and 25 cases of HPV negative and normal cervical biopsy( negative control group) patients. Results:(1)The results of peripheral blood immunoglobulin detection:IgA,IgG and IgM as well as C3 and C4 were no significant differences among negative control group,LSIL group,HSIL group,and early cervical cancer group( P>0. 05). However,it seemed that IgA increased with cervical lesions advancing.(2)The results of cytokines in vaginal lavage detection:The expression of IL-2 gradually decreased in the negative control group,LSIL group,HSIL group and early cervical cancer. The difference of four groups was statistically significant( P< 0. 001). However,the expression of IL-10 increased with the progress of cervical lesions. The difference was also significant( P< 0. 05). Conclusion: As cervical partial lesions,CIN and early stage cervical cancer affected little on humoral immunity except IgA,which was related to mucous immunity. But cervical lesions can reduce local immunity of vagina and promote cervical lesions. Therefore,the change of IL-2 and IL-10 in vaginal lavage may be one of the warning indicators for cervical lesions advancing.
Objective:To study the relationship between cervical intraepithelial lesion(CIN) and early cervical cancer and systemic and local humoral immunity of the patients. Methods: Peripheral blood immunoglobulin IgA,IgG,IgM and C3 and C4,and vaginal lavage the immune cytokine interleukin-2( IL-2) and interleukin 10( IL-10) were detected by 103 cases of cervical intraepithelial lesions( including 20 cases of LSIL and 83 cases of HSIL),60 cases of stage Ⅰ cervical cancer,and 25 cases of HPV negative and normal cervical biopsy( negative control group) patients. Results:(1)The results of peripheral blood immunoglobulin detection:IgA,IgG and IgM as well as C3 and C4 were no significant differences among negative control group,LSIL group,HSIL group,and early cervical cancer group( P>0. 05). However,it seemed that IgA increased with cervical lesions advancing.(2)The results of cytokines in vaginal lavage detection:The expression of IL-2 gradually decreased in the negative control group,LSIL group,HSIL group and early cervical cancer. The difference of four groups was statistically significant( P< 0. 001). However,the expression of IL-10 increased with the progress of cervical lesions. The difference was also significant( P< 0. 05). Conclusion: As cervical partial lesions,CIN and early stage cervical cancer affected little on humoral immunity except IgA,which was related to mucous immunity. But cervical lesions can reduce local immunity of vagina and promote cervical lesions. Therefore,the change of IL-2 and IL-10 in vaginal lavage may be one of the warning indicators for cervical lesions advancing.
引文
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[9]Hu YJ,Li L,Gong SX.Regulatory effect of astragalus injection on Th1/Th2 cell function in patients with cervical cancer[J].Zhong Guo Zhong Xi Yi Jie He Za Zhi.2010 30(11):1157-1159.
[10]Laager GB,llse Beckmann,Patricia C Ewing,et al.Cytokine Release in HR-HPV(+)women without and with cervical dysplasia(CINII and CINIII)or Carcinoma,compared with HR(-)controls[J].Med Infammat,2007,24147:1-8.
[11]Lee BN,Follen M,Shen DY,et al.Depressed type 1 cytokine synthesis by superantigen-activated CD4+T cells of women with humanpapillomavirus-relatedhigh-gradesquamousintraepithelial lesions[J].Clin Diagn Lab Immunol,2004,11(2):239-244.
[12]El-Sherif AM,Seth R,Tighe PJ,et al.Quantitative analysis of IL-10 and IFN-gamma mRNA levels in normal cervix and human papillomavirus type 16 associated cervical precancer[J].JPathol,2001,195:179.
[2]何维.医学免疫学[M].北京:人民卫生出版社,2005:214-215.He W.Medical Immunity[M].Beijing:People's Medica Publishing House,2005:214-215..
[3]Kuss I.Decreased,absolute counts of T lymphocytesubsetsand their relation to disease in squamous cell carcinoma of the head and neck[J].Clin Cancer Res,2004,10(11):3755.
[4]陈大宇,黄献文.小儿手足口病免疫球蛋白与超敏C反应蛋白的检测分析[J].中国全科医学,2011,14(5):476-477.Chen DY,Huang XW.Detection and analysis of immunoglobulin and hypersensitive C reactive protein in children with hand foot and mouth disease[J].Chin General Pract,2011,14(5):476-477.
[5]王耿新,张美莲,陈传刚.786例恶性肿瘤患者免疫球蛋白检测结果分析[J].中华医学杂志,2005,29(4):302-303.Wang GX,Zhang ML,Chen CG.Analysis of immunoglobulin detection results in 786 cases of patients with malignant tumor[J].Chin Med J,2005,29(4):302-303.
[6]王晓洪.恶性肿瘤患者血清免疫球蛋白检测结果分析[J].中国民康医学,2015,27(1):83-84.Wang XH.Analysis of serum immunoglobulin in patients with malignant tumor[J].Med J Chin People Health,2015,27(1):83-84.
[7]王育芳,王佳丽,马顺高.肿瘤患者血清免疫球蛋白检测结果分析[J].中外健康文摘,2012,9(29):225-227.Wang YF,Wang JL,Ma SG.Analysis of serum immunoglobulin test results[J].World Health Digest,2012,9(29):225-227.
[8]刘薇,汤春生.Th1/Th2细胞与妇科肿瘤[J].国外医学妇产科学分册,2002,29(4):209-210.Liu W,Tang CS.Th1/Th2 cell and gynecological tumor[J].Volume of Gynecology and Obstetrics of Foreign Medical Sciences,2002,29(4):209-210.
[9]Hu YJ,Li L,Gong SX.Regulatory effect of astragalus injection on Th1/Th2 cell function in patients with cervical cancer[J].Zhong Guo Zhong Xi Yi Jie He Za Zhi.2010 30(11):1157-1159.
[10]Laager GB,llse Beckmann,Patricia C Ewing,et al.Cytokine Release in HR-HPV(+)women without and with cervical dysplasia(CINII and CINIII)or Carcinoma,compared with HR(-)controls[J].Med Infammat,2007,24147:1-8.
[11]Lee BN,Follen M,Shen DY,et al.Depressed type 1 cytokine synthesis by superantigen-activated CD4+T cells of women with humanpapillomavirus-relatedhigh-gradesquamousintraepithelial lesions[J].Clin Diagn Lab Immunol,2004,11(2):239-244.
[12]El-Sherif AM,Seth R,Tighe PJ,et al.Quantitative analysis of IL-10 and IFN-gamma mRNA levels in normal cervix and human papillomavirus type 16 associated cervical precancer[J].JPathol,2001,195:179.