T细胞亚群及Ki67在宫颈人乳头状瘤病毒感染进程中的变化及意义

目的 研究人乳头状瘤病毒(HPV)感染进程中,患者CD4+、CD8+T细胞亚群和Ki67的水平变化并探讨其临床意义.方法 2009年3月-2010年12月医院妇科进行宫颈活检的120例患者纳入研究,其中宫颈上皮肉瘤样病变(CIN)Ⅰ、Ⅱ、Ⅲ级以及宫颈鳞癌患者各30例,均为HPV阳性,此外选择同期就诊的30例慢性宫颈炎、HPV阴性患者作为对照组；采用流式细胞仪检测患者外周血的CD4+和CD8+T细胞,采用免疫组化的方法检测病变组织中Ki67的表达.结果 宫颈上皮肉瘤样病变CIN Ⅰ级外周血的CD4+T细胞水平为(562.8±74.5)、CINⅡ级为(446.1±73.5)、CINⅢ级为(315.7±62.4)、宫颈癌组为(235.2±39.9)个/μl,均显著低于对照组的(621.3±87.4)个/μl；并且随着HPV感染的进展,CD4+T细胞水平逐渐降低；CIN Ⅰ级外周血的CD8+T细胞水平为(578.3±77.9)、CINⅡ级为(642.8±82.9)、CINⅢ级为(712.3±85.5)和宫颈癌组(768.4±86.6)个/μl,均显著高于对照组；并且随着HPV感染的进展,CD8+T细胞水平逐渐升高；CIN Ⅰ级病变组织Ki67表达阳性率为20.0％、CINⅡ级为46.7％、CINⅢ级为73.3％和宫颈癌组93.3％,均显著高于对照组的3.3％；并且随着HPV感染的进展,Ki67表达阳性率逐渐升高.结论 HPV感染进程中伴随CD4+T细胞降低、CD8+T细胞以及Ki67升高,免疫功能的降低以及Ki67表达的上调,在宫颈HPV感染进程中起重要作用.

Change and significance of T-cell subsets and Ki67 during progress of HPV infection at cervix

OBJECTIVE To investigate the change of CD4+,CD8+ subpopulations and Ki67 expression during the progress of HPV infection at cervix and explore the clinical significance.METHODS A total of 120 patients who underwent the cervical biopsy during Mar 2009-Dec 2010 were recruited.There were 30 cases respectively in CIN Ⅰ grade group,CIN Ⅱ grade group,CIN Ⅲ grade group and cervical squamous cell carcinoma group,and all of them were HPV positive.30 patients with chronic cervicitis were selected as control group,in which HPV was negative.CD4+ and CD8+ populations in peripheral blood were determined by flow cytometry,and Ki67 expression was determined by immunohistochemistry.RESULTS The CD4+ population in each group were(562.8±74.5),(446.1±73.5),(315.7±62.4) and(235.2±39.9) cells/μl,which were all lower than control group,and CD4+ population decreased with the progress of HPV infection.The CD8+ population in each group were(578.3±77.9),(642.8±82.9),(712.3±85.5) and(768.4±86.6) cells/μl,which were all higher than control group,and CD8+ population increased with the progress of HPV infection.The positive rate of ki67 staining in each group were 20.0%,46.7%,73.3% and 93.3%,which were all higher than control group,and the positive rate of ki67 increased with the progress of HPV infection.CONCLUSION CD4+ population decreases,CD8+ population and ki67 expression increase during the progress of HPV infection.Decrease of immunity and increase of ki67 expression play important roles during the progress of HPV infection.