目的比较宫颈局部微环境高危型人乳头状瘤病毒载量(HR-HPV DNA)和CD4+CD25+Foxp3+调节性T细胞(Treg)的同步变化,探讨HR-HPV病毒复制和宫颈病变进展两者同时对Treg细胞的影响。方法将304例HR-HPV持续感染者依宫颈病变的不同分为5组:宫颈...目的比较宫颈局部微环境高危型人乳头状瘤病毒载量(HR-HPV DNA)和CD4+CD25+Foxp3+调节性T细胞(Treg)的同步变化,探讨HR-HPV病毒复制和宫颈病变进展两者同时对Treg细胞的影响。方法将304例HR-HPV持续感染者依宫颈病变的不同分为5组:宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ、宫颈癌和慢性宫颈炎,采用PCR荧光法检测宫颈分泌物HPV-DNA,应用流式细胞仪CD4+CD25+Foxp3+设门方法对宫颈刷检物中的CD4+CD25+Treg细胞相对计数,对数据资料进行统计学分析。结果(1)宫颈局部Treg细胞表达在不同程度的宫颈病变和不同拷贝数的病毒载量之间比较差异均有显著性(F=24.93,109.86,P<0.05),进一步的两两比较显示,Treg细胞的水平变化在慢性宫颈炎和CINⅠ之间以及低载量(HPV DNA 104~105copies/m L)和中载量(HPV DNA 105~106copies/m L)之间差异无统计学意义(P>0.05),其他组组间比较差异有统计学意义(P<0.05);(2)以Treg细胞水平变化为变量,宫颈病变和病毒载量为因子的交互效应显著(F=3.39,P<0.05),不同的宫颈病变,HR-HPV病毒载量对Treg表达的影响大小不一,总体呈现随着宫颈病变程度加重,HR-HPV病毒拷贝数升高,Treg细胞表达Foxp3+逐步上升的趋势;(3)宫颈癌患者高表达CD4+CD25+Foxp3+Treg细胞,但表达水平波动范围大,数值分布最为分散。结论宫颈局部微环境CD4+CD25+Foxp3+Treg细胞的免疫抑制功能在不同宫颈病变和不同HR-HPV DNA中可能通过双向性调节,影响宫颈病变转归,就整体变化而言,Treg细胞、HR-HPV载量、宫颈病变三者呈相向的进展趋向。展开更多
目的：探讨医院机会性筛查人群初次高危型人乳头瘤（ high risk human papillomavirus,HR-HPV）感染后病毒自然清除或持续感染的相关因素。方法随访2013年1月1日到2013年12月31日首都医科大学附属北京朝阳医院妇产科初次HR-HPV阳性患者...目的：探讨医院机会性筛查人群初次高危型人乳头瘤（ high risk human papillomavirus,HR-HPV）感染后病毒自然清除或持续感染的相关因素。方法随访2013年1月1日到2013年12月31日首都医科大学附属北京朝阳医院妇产科初次HR-HPV阳性患者969例。观察HR-HPV感染患者病毒自然清除特征及相关因素,分析年龄、病毒基因分型、多重感染以及初次感染病毒负荷量与病毒自然消除及持续性感染的关系。 SPSS 18.0统计软件进行统计学处理,Kaplan-Meier生存分析用于计算病毒清除时间。 COX比例风险回归用于病毒清除相关因素分析。结果969例HR-HPV 感染患者平均病毒清除时间为9.52（95% CI：9.09~9.95）个月,中位消退时间8（95% CI：7.65~8.36）个月。不同年龄组HR-HPV自然清除的时间不同（X2=7.93,P=0.047）。不同亚型HPV自然清除时间不同,清除时间最长的前5位分别是HPV56型、HPV33型、HPV58型、HPV52型、HPV18型。病毒清除时间最短的是依次HPV45型、HPV51型、HPV68型。多病毒联合感染同病毒持续感染相关,联合感染者病毒清除时间明显延长,持续感染时间延长（X2=18.67,P=0.000）。初次感染的病毒负荷量不同,病毒自然清除时间不同,差异有统计学意义（X2=18.68,P=0.000）。 COX比例风险回归分析显示：年龄（回归系数为-0.082,P=0.046）及多病毒联合感染（回归系数为-0.231,P=0.037）同病毒清除呈负相关,初次感染病毒负荷量分级（回归系数为-0.185,P=0.108）与病毒自然清除时间无相关。结论 HR-HPV基因型为HPV56型、HPV35型、HPV58型、HPV51型、HPV35型,≧50岁女性、多重感染以及初次高病毒负荷量患者,病毒自然清除时间长,更易发生持续性感染。展开更多
Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be...Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be spontaneously cured.However,the infection sometimes can be responsible for an intraepithelial lesion,which may progress to be cervical cancer.Cervical cancer is one of the most common neoplastic diseases affecting women.It is clear that carcinogenic HPV infection is the necessary process for the development of cervical cancer.HPV infection is very frequent in young women aged less than 25 years and viral clearance lasts for 8 months in average.This clearance is the consequence of host immunity intervention,which leads to spontaneous regression of infection and the overwhelming majority of low-grade squamous intraepithelial lesions(more than 80% within a period of 2 years).The major factor,which permits the progression to high grade squamous intraepithelial lesions and invasive cervical cancer,is the persistent feature of HPV infection.HPV infection is usually transient,but several factors were identified as host factors(genetic,immunodepression,oral contraception and smoking) and viral factors(genotype,variants,viral load and integration) to increase the persistence.Cervical cancer is clearly the first virus-induced solid tumor discovered in human.Furthermore,it represents a woman death cause that can be avoided.展开更多
文摘目的比较宫颈局部微环境高危型人乳头状瘤病毒载量(HR-HPV DNA)和CD4+CD25+Foxp3+调节性T细胞(Treg)的同步变化,探讨HR-HPV病毒复制和宫颈病变进展两者同时对Treg细胞的影响。方法将304例HR-HPV持续感染者依宫颈病变的不同分为5组:宫颈上皮内瘤变(CIN)Ⅰ、CINⅡ、CINⅢ、宫颈癌和慢性宫颈炎,采用PCR荧光法检测宫颈分泌物HPV-DNA,应用流式细胞仪CD4+CD25+Foxp3+设门方法对宫颈刷检物中的CD4+CD25+Treg细胞相对计数,对数据资料进行统计学分析。结果(1)宫颈局部Treg细胞表达在不同程度的宫颈病变和不同拷贝数的病毒载量之间比较差异均有显著性(F=24.93,109.86,P<0.05),进一步的两两比较显示,Treg细胞的水平变化在慢性宫颈炎和CINⅠ之间以及低载量(HPV DNA 104~105copies/m L)和中载量(HPV DNA 105~106copies/m L)之间差异无统计学意义(P>0.05),其他组组间比较差异有统计学意义(P<0.05);(2)以Treg细胞水平变化为变量,宫颈病变和病毒载量为因子的交互效应显著(F=3.39,P<0.05),不同的宫颈病变,HR-HPV病毒载量对Treg表达的影响大小不一,总体呈现随着宫颈病变程度加重,HR-HPV病毒拷贝数升高,Treg细胞表达Foxp3+逐步上升的趋势;(3)宫颈癌患者高表达CD4+CD25+Foxp3+Treg细胞,但表达水平波动范围大,数值分布最为分散。结论宫颈局部微环境CD4+CD25+Foxp3+Treg细胞的免疫抑制功能在不同宫颈病变和不同HR-HPV DNA中可能通过双向性调节,影响宫颈病变转归,就整体变化而言,Treg细胞、HR-HPV载量、宫颈病变三者呈相向的进展趋向。
文摘Human papillomavirus(HPV) genital infection is a very common sexual transmitted disease.Mostly,the infection is transient and asymptomatic.The induction of effective immune responses usually allows the infection to be spontaneously cured.However,the infection sometimes can be responsible for an intraepithelial lesion,which may progress to be cervical cancer.Cervical cancer is one of the most common neoplastic diseases affecting women.It is clear that carcinogenic HPV infection is the necessary process for the development of cervical cancer.HPV infection is very frequent in young women aged less than 25 years and viral clearance lasts for 8 months in average.This clearance is the consequence of host immunity intervention,which leads to spontaneous regression of infection and the overwhelming majority of low-grade squamous intraepithelial lesions(more than 80% within a period of 2 years).The major factor,which permits the progression to high grade squamous intraepithelial lesions and invasive cervical cancer,is the persistent feature of HPV infection.HPV infection is usually transient,but several factors were identified as host factors(genetic,immunodepression,oral contraception and smoking) and viral factors(genotype,variants,viral load and integration) to increase the persistence.Cervical cancer is clearly the first virus-induced solid tumor discovered in human.Furthermore,it represents a woman death cause that can be avoided.
