| Objective:To investigate systemic immune function cervical cervical local of microenvironment intraepithelial neoplasia and early cervical cancer.studying the relationship among systemic immune,vaginal flora imbalance,local T lymphocyte subsets,inflammatory factors and CIN,further comparative analysis of the systemic immune CIN and cervical local immune changes,preliminary understanding the relationship between CIN and systemic and local immune changes.Methods:254 cases with aged 20 to 65 years and sexually active women who were Selected women from January 2015 to December 2016 in Gynecology Oncology of Guangxi Tumor Hospital,Guangxi Women's hospital and Guangxi Liuzhou Workers Hospital,cervical cytology(TCT)and a flow check hybridization microarray chips HPV-DNA,the final selection is confirmed by biopsy,A total of 77 patients with chronic inflammatory syndrome and 142 patients with CIN were enrolled in the study group(52 cases of Low cervical intraepithelial neoplasia LSHL group,90 cases of High Cervical Intraepithelial Neoplasia HSIL group,35 cases of control group(normal cervical biopsy),The above patients were collected at the time of initial diagnosis of vaginal secretions and vaginal discharge required for vaginal discharge,vaginal secretions with a precision PH test paper pH,Gram stain detection Lactobacillus,mold,clue cells,vaginal flora with suspended droplets Detection of trichomonas by wet film method.the vaginal lavage fluid was collected by enzyme digestion assay(Enzyme linked immunosorbent assay ELISA)Phytophthora:(cytokine Interleukin-2(Interleukin-2 IL-2)Interleukin,Interleukin-10(Interleukin-10 IL-10),CD4 +and CD8 +.Cervical Intraepithelial Neoplasia(CIN)including 20 cases of LSIL group,56 cases of HSIL,60 cases of cervical cancer(cervical cancer group)peripheral blood samples,25 cases of Cervical healthy people(control group)humoral immune test indicators Included:immunoglobulin(IgA + IgG + IgM)and complement(C3 + C4).Cellular immunity included CD3(total T lymphocyte),CD4(helper lymphocyte Th),CD8(inhibitory lymphocyte Ts),CD4/CD8(Th/Ts),and the results were compared and analyzed.Results:1.IgA in control group,LSIL group,HSIL group and cervical cancer group was no statistically significant(P=0.256<0.05);There was no significant difference in IgG among control group?LSIL group?HSIL group and cervical cancer group(P=0.558>0.05);There was no significant difference in IgM among control group?LSIL group?HSIL group and cervical cancer group(P =0.731>0.05).There was no significant difference in complement C3 among thecontrol group?the LSIL group?HSIL group and the cervical cancer group(P=0.362>0.05).There was no significant difference in complement C4 between the control group,LSIL group and the cervical cancer group(P = 0.413>0.05)..2.CD3 + in control group,LSIL group,HSIL group and cervical cancer group,the difference was statistically significant(P=0.002<0.05).CD4+ has a significant difference among control group,LSIL group,HSIL group and cervical cancer group P=0.038<0.05);There was no significant difference in CD8 + among control group,LSIL group,HSIL group and cervical cancer group(P = 0.075>0.05).There was no significant difference in the ratio of CD4+/CD8 + between control group,LSIL group,HSIL group and cervical cancer group(P = 0.059>0.05).3.HPV infection in cervical exfoliated cells:254 patients with HPV infection rate was 78.54%,The infection rates of HPV16 and 58 were 7.14%,15.38%,65.56%and 5.19%,9.62%,11.11%.The infection rates of HPV16 and 58 were increased with the increase of cervical lesions.The infection rates of HPV52 were 15.58%,30.77%,10%,HPV52 infection in the lower cervical lesions is more common,high-risk HPV infection was respectively 49.35%,67.35%and 93.33%in the inflammatory group,LSIL group and HSIL group.with the severity of cervical lesions,the high risk HPV increased,and the difference was statistically significant(P<0.05).4.Vaginal PH value and flora detection:Vaginal PH are in the control group,the inflammation group,the LSIL group and the HSIL group,(4.6 ± 0.78),(4.6± 0.71),(4.8 ± 0.59)and(5.1 ± 0.53),respectively,there was statistically significant in pH value among the four groups(P<0.05).The positive rate of Lactobacillus among control group,inflammatory group,LSIL group and HSIL group was significantly higher than that in LSIL group and HSIL group(P<0.05),and the difference was statistically significant(8.57%,7.79%,7.69%and 3.33%,respectively).The positive rate of Lactobacillus decreased with the increase of cervical lesion,but there was no significant difference between the four groups(P>0.05).The infection rates of Trichomonas vaginalis TV were 8.57%,9.09%,11.54%and 6.67%,respectively,and the difference was not statistically significant(P>0.05).The infection rates of Candida albicans were 11.43%,9.09%,13.46%and 11.11%,respectively.There was no significant difference(P>0.05).The infection rates of Bacterial vaginosis BV were 8.57%,5.19%9.62%,10%,the difference was not statistically significant(P>0.05).5.The levels of IL-2 in the vaginal lavage fluid were 171.02 ± 22.75 pg/ml,173.31 ± 19.72 pg/ml,155.09 ± 33.78 pg/ml in the control group,the inflammatory group,the LSIL group and the HSIL group,respectively(P<0.001).IL-10 was significantly higher in the control group,the inflammation group,the LSIL group and the HSIL group(P<0.001),and the difference was statistically significant(P<0.001)in the inflammatory group,LSIL group and HSIL group IL-10 in the inflammatory group,LSIL group and HSIL group were higher than those in the control group,the difference was significant(P<0.05).IL-10 in the inflammatory group,LSIL group and HSIL group was higher than that in the control group,43.91±11.16pg/ml?46.53±14.61pg/ml?50.17±16?77pg/ml?55.36± 20.46pg/ml/Statistically significant(P<0.05).6.The detection of T-lymphocyte subsets in vaginal lavage:CD4 + in the control group,inflammatory group,LSIL group and HSIL group were 27.09 ±5.09ug/L,25.98 ± 7.81ug/L,25.58 ± 6.92ug/L,25.24 ± 5.33ug/L;there was no significant difference between the two groups(P>0.05).CD8 + in the control group,inflammatory group,LSIL group and HSIL group were 31.07 ± 4.85IU/mL,31.52 ± 8.19IU/mL,32.30 ± 5.81U/mL,33.99 ± 7.96IU/mL respectively.(P>0.05).7.The CD4 + in the immunized T lymphocyte subsets was statistical significance(P<0.001)in the control group,LSIL group and HSIL group,while CD4 + in the local immunized T lymphocyte subsets was not statistically significant among the three groups(P>0.05),CD8 + in the whole body and local T lymphocyte subsets were not statistically significant.6.The risk factors of the control group or inflammation group turning to HSIL were HPV infection,decrease of PH value and IL2.The risk factor of LSIL group into HSIL group was PH value.Conclusion:1.With the progress of CIN to cervical cancer,mainly showing as Lower of the cellular immunity ability,Conclusion Cellular immune function of cervical lesions was reduced and no change in humoral immunity function wasobserved.2.High-risk HPV infection rate increased with the degree of cervical lesions increased,HPV infection was a risk factor for CIN progression;3.Vaginal pH increased with the severity of cervical lesions,PH value was an important risk factor for CIN progression.But But it was not sure that there was a link among trichomonas vaginitis,bacterial vaginal disease,vulva vagina candida disease and CIN.4.With the degree of cervical lesions increased,IL-2 which was vaginal local inflammatory cytokines gradually decreased,IL-10 increased,suggesting that t IL-2 and IL-10 the local microenvironment played an important role in the cervical lesions.5.The change of cervical local humoral immune factors was an important factor of cervical lesion,the immunoglobulin except IgA and complement had a little influence on Body fluid immunity.6.Changes of T lymphocyte subgroup played an important role in the progress of cervical lesions,local changes of T lymphocyte subgroup still needed to continue studying. |
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