子宫颈上皮内瘤变患者CD4＋、CD8＋T细胞表达与高危型HPV感染的关系

目的探讨不同级别宫颈上皮内瘤变（CIN）组织中CD4＋、CD8＋T细胞表达及与高危型人乳头瘤病毒（HR-HPV）的关系。方法对2005年1月至2008年8月在珠海市人民医院阴道镜下宫颈活检诊断为CIN并行宫颈锥切治疗的72例患者的资料进行分析,采用杂交捕获第二代方法（HC-Ⅱ）检测高危型HPVDNA含量;采用免疫组化检测30例CIN1、43例CIN2/3及10例正常宫颈组织中CD4＋、CD8＋T细胞的表达。结果 CIN2/3组的HR-HPV感染率显著高于CIN1组（P〈0.05）,CIN组HR-HPV感染率高于慢性宫颈炎组（P〈0.01）。慢性宫颈炎组、CIN1组和CIN2/3组CD4＋T细胞表达率分别为60.0%、43.3%和33.3%,CD8＋T细胞的表达率分别为70.0%、46.7%和31.0%;CD4＋、CD8＋T细胞在CIN1组及CIN2/3组的表达显著低于慢性宫颈炎组（P〈0.05）。结论 CD4＋、CD8＋T细胞表达下调可能促进宫颈HR-HPV感染的发生,并对宫颈癌前病变的发生、发展起一定的作用。

The relationship between the expressions of CD4+,CD8+ T cell and high risk human papillomavirus in cervical intraepithelial neoplasia

Objective To investigate the expression of CD4+,CD8+ T cell and hrHPV virus load in cervical intraepithelial neoplasia(CIN)and the value of HPV vaccine selection.Methods Data of 72 patients who underwent LEEP for CIN between January 2005and August 2008 in the People’s Hospital of Zhuhai were analyzed retrospectively.The expression of CD4+,CD8+ T cell in 30CIN1,43CIN2/3 and 10normal cervical tissue specimens was determined by immunohistochemical method.hrHPV DNA virus load was detected by HC-Ⅱsystem.Results hrHPV-DNA virus load in normal group,CIN1and CIN2/3 group were (6.47±12.83)pg/ml, (187.64± 169.31)pg/ml and (312.46±287.46)pg/ml.hrHPV-DNA virus load in CIN group was significant higher than that in normal group (P<0.01),and hrHPV-DNA virus load in CIN2/3group was higher than in that in CIN 1 group(P<0.05).In normal group,CIN1and CIN2/3 group,the expression rate of CD4+T cell was 60.0%, 43.3% and 33.3%,the expression rate of CD8+ T cell was 70.0%,46.7%and 31.0%.The expression of CD4+ and CD8+ T cell in CIN groups was significant lower than that in normal group(P<0.05).Conclusion Decreased expression of CD4+,CD8+ T cell may result in high hrHPV-DNA virus persistence and thus enhance cervical cancerous.