| [Objective] Cervical intraepithelial neoplasia (CIN) is precancerous lesions of cervical cancer, caused by persistent human papilloma virus (HPV) infection. The chance of HPV infection during a woman’s lifetime is up to80%, but most women can clear the virus within a few months. Only a few will be infected persistently, hence suffer CIN or cervical cancer. A successful immune response directed against HPV and premalignant epithelial cells is believed crucial for clearance of the lesions. The aim of our study is to evaluate the characteristics of systemic cell-mediated immunity and the alterations of dendritic cells in patients with CIN. Then we evaluated the effect of two kinds of topical interferon on cervical HPV infection, and used Logistic regression to find the predictvie factors of drug effect.[Methods] In the first part of the study:specific fluorescent markers were used to detect T lymphocyte subsets in peripheral blood by flow cytometry. In the second part:we analyzed retrospectively the data of patients with cervical HPV infection who were admitted in outpatient department of our hospital.[Results] The first part indicated that with the increased level of lesions, the proportion of CD4+T cells of patients with CIN decreased, while that of CD8+T cells gradually increased, but the results were not statistically significant. Compared with healthy controls, the ratio of CD4+T cells to CD8+T cells in patients with CIN2and CIN3both decreased, which were1.46±0.43,1.05±0.52and0.99±0.58respectively, and the results were statistically significant. No significant difference between groups was detected in activated subsets of CD8+T cells (CD38, HLA-DR), naive subsets (CD45RA) and memory subsets (CD45RO) of CD4+T cells and CD8+T cells. Activated subsets of CD4+T cell (HLA-DR) in patients with CIN3was more than that in healthy controls (17.8%±6.1%vs.11.5%±5.4%). The proportion of denditritic cell subsets of patients with CIN1-3has no difference from that of controls. The second part indicated that308eligible patients were included, in which174patients were treated by gel preparation,134patients by gel preparation. The failure rate of gel preparation group was lower than that of capsule group (26.4%vs.35.1%, P=0.102), but the result was not statistically significant. Compared with capsule group, gel preparation group was associated with higher complete response (65.5%vs.51.5%, P=0.01) and lower clearance rate(23.0%vs.34.3%, P=0.03). Multivariate analysis showed colposcopic biopsy before treatment (OR=1.926,95%CI1.062-3.494), age (OR=1.730,95%CI1.065-2.812), and HPV DNA load of the first test (OR=1.948,95%CI1.191-3.187) were independent predictive factors for complete response, drug (OR=4.586,95%CI2.692-7.812), age (OR=0.579, 95%CI0.348-0.936),interval time (OR=1.203,95%CI1.056-1.371) for HPV clearance.[Conclusions] Firstly, the systematic immunity in patients with CIN has been altered by disease, which lay a foundation of immunological therapy for these patients. Secondly, interferon in gel preparation and capsule both have their respective advantages, further study should explore their optimal dose and whether they can be usedjointly for cervical HPV infection.
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