Mu Lin, Miao Jing-Rui, Song Jing-Hui
Department of Obstetrics and Gynecology, Affiliated Hospital of Inner Mongolia Medical University, Inner Mongolia, China.
Transl Cancer Res. 2020 Jul;9(7):4212-4223. doi: 10.21037/tcr-19-2955.
This study aimed to investigate the correlation between the level of HPV16 and HPV18 in patients with cervical lesions and the local vaginal immunity after receiving treatment with different degrees of cervical intraepithelial neoplasia (CIN) and cervical squamous cell carcinoma (CSCC).
One hundred and thirty-six patients with LSIL (grade 1 CIN or CIN 1), 263 patients with HSIL (grade 2 and 3 CIN or CIN 2 and 3), and 33 patients with CSCC pathologically confirmed between November 2012 and September 2016 were assigned to the test group and 100 healthy women in the same period were assigned to the control group. ELISA was used to determine the levels of SIgA, IgG, IL-2, and IL-10 and the IL-2/IL-10 ratio in vaginal lavage fluid in the test group (before treatment and 3, 6, and 12 months after treatment) and the control group, respectively. Gene chip technology was adopted to test the HPV infection in the test group (before treatment and 3, 6, and 12 months after treatment) and the control group, respectively.
The results showed that the levels of SIgA, IgG, and IL-10 were positively correlated with the degree of cervical lesions and IL-2/IL-10 was negatively correlated with the degree in all patients before treatment. The levels of SIgA, IgG, and IL-10 were positively correlated with the degree of cervical lesions and IL-2/IL-10 was negatively correlated with the degree in HPV16 and HPV18-infected patients before receiving the treatment.
The recovery after the treatment of HPV infection is time-dependent and the immune system of patients with CIN starts to recover in the 6th month after treatment, early intervention is not recommended. However, the immune system is approximately in a normal sate at 12 months after treatment, at which time the efficacy can be evaluated, and clinical intervention can be initiated if necessary. The level of local immune factors in the vagina can be monitored to determine the progression and prognosis of patients' cervical lesions.
本研究旨在探讨宫颈病变患者中HPV16和HPV18水平与不同程度宫颈上皮内瘤变(CIN)及宫颈鳞状细胞癌(CSCC)治疗后局部阴道免疫之间的相关性。
将2012年11月至2016年9月间病理确诊的136例低级别鳞状上皮内病变(LSIL,即1级CIN或CIN 1)患者、263例高级别鳞状上皮内病变(HSIL,即2级和3级CIN或CIN 2和3)患者以及33例CSCC患者纳入试验组,同期100例健康女性纳入对照组。分别采用酶联免疫吸附测定法(ELISA)检测试验组(治疗前及治疗后3、6和12个月)和对照组阴道灌洗液中分泌型免疫球蛋白A(SIgA)、免疫球蛋白G(IgG)、白细胞介素-2(IL-2)和白细胞介素-10(IL-)水平及IL-2/IL-10比值。分别采用基因芯片技术检测试验组(治疗前及治疗后3、6和12个月)和对照组的HPV感染情况。
结果显示,治疗前所有患者中,SIgA、IgG和IL-10水平与宫颈病变程度呈正相关,IL-2/IL-10与宫颈病变程度呈负相关。在接受治疗前,HPV16和HPV18感染患者中,SIgA、IgG和IL-10水平与宫颈病变程度呈正相关,IL-2/IL-10与宫颈病变程度呈负相关。
HPV感染治疗后的恢复具有时间依赖性,CIN患者的免疫系统在治疗后第6个月开始恢复,不建议早期干预。然而,治疗后12个月时免疫系统大致处于正常状态,此时可评估疗效,必要时可启动临床干预。可通过监测阴道局部免疫因子水平来判断患者宫颈病变的进展及预后。