摘要
目的:探讨宫颈病变中IFN-γ、IL-10的表达与高危型HPV感染的关系及中药清热扶正法对其表达的影响。方法:收集2012年6月—2014年6月期间宫颈标本104例为研究组,经病理确诊宫颈鳞癌48例,CIN56例。48例宫颈鳞癌按照临床分期:Ⅰ期16,Ⅱ期24例,Ⅲ期8例;56例CIN中:CINⅠ15例,CINⅡ19例,CINⅢ22例。选择正常宫颈组织标本40例为对照组。检测宫颈癌、CIN等宫颈病变组织中IFN-γ、IL-10的表达情况及HR-HPV感染情况。结果:宫颈癌组HR-HPV感染率(87.5%)高于CIN组(75.0%)和对照组(10.0%),且CIN组HR-HPV感染率高于对照组(P<0.05),有统计学意义(P<0.05);CINⅠ、CINⅡ、CINⅢ3组HR-HPV感染率分别为46.7%(7/15)、78.9%(15/19)、90.9%(20/22),随着CIN级别的增加,HR-HPV感染率呈现升高趋势(χ2=9.5498,P=0.0084,P<0.05);宫颈癌组IFN-γIOD值低于CIN组和对照组,差异有统计学意义(P<0.01),CIN组IFN-γIOD值低于对照组,差异有统计学意义(P<0.01);宫颈癌组IL-10 IOD值高于CIN组和对照组,差异有统计学意义(P<0.01),CIN组IL-10 IOD值高于对照组,差异有统计学意义(P<0.01);随着CIN级别的增加,IFN-γ的表达呈减弱趋势,IL-10的表达呈增强趋势,且3组间两两比较均有统计学差异(P<0.01);随着宫颈癌临床分期的增加,IFN-γ的表达呈减弱趋势,IL-10的表达呈增强趋势,且3组间两两比较均有统计学差异(P<0.01);HR-HPV阳性组IFN-γIOD值低于HR-HPV阴性组,差异有统计学意义(P<0.01);HR-HPV阳性组IL-10 IOD值高于HR-HPV阴性组,差异有统计学意义(P<0.01);治疗后CIN组血清IFN-γ水平高于治疗前,CIN组血清IL-10水平低于治疗前,差异有统计学意义(P<0.01);宫颈组织中IFN-γ的表达与CIN分级、宫颈癌临床分期、HR-HPV感染均呈负相关(P<0.05);宫颈组织中IL-10的表达与CIN分级、宫颈癌临床分期、HR-HPV感染均呈正相关(P<0.05)。结论:宫颈病变患者宫颈组织中IL-10呈高表达,IFN-γ呈低表达,宫颈组织中IL-10、IFN-γ的表达与宫颈病变的发生、进展及HPV感染密切相关。中药清热扶正法可有效调节CIN患者体内IL-10、IFN-γ水平。
Objective： To study expression of IFN-γ and IL-10 in cervical lesion and the correlation with HR-HPV infection and the influence of method of invigorating vital essence of traditional Chinese medicine on its expression. Methods： During June 2012 to June 2014,104 cases of cervical specimens were collected as the study group. According to the pathological diagnosis of cervical squamous carcinoma in 104 cases,48 cases were cervical squamous carcinoma and 56 cases were CIN. 48 cases of cervical squamous carcinoma according to the clinical stages： stage I 16 cases,stage II 24 cases,stage III 8 cases; 56 cases of CIN,CIN I 15 cases,CIN II 19 cases,CIN III 22 cases. 40 cases of specimens of normal cervical tissue were selected as the control group. The detection of IFN-γ the expression of IL-10 and HR-HPV infection of cervical cancer and CIN cervical lesion were carried on. Results： HR-HPV infection rate（87. 5%） in cervical group was higher than that of CIN group（75. 0%） and the control group（10. 0%） and CIN group HR-HPV infection rate was higher than that of the control group with statistical significance（P〈0. 05）. CIN I,CIN II,CIN III HR-HPV infection rates were 46. 7%（7/15）,78. 9%（15/19） and 90. 9%（20/22）. With the level increasing of CIN,HR-HPV infection rate showed a trend of increase（chi-square = 9. 5498,P = 9. 5498,P〈0. 05）. Cervical cancer group＇s IFN-γ IOD values were lower than that of CIN group and the control group and the difference was statistically significant（P〈0. 01）. CIN group＇s IFN-γ IOD value was lower than that of the control group and the difference was statistically significant（P〈0. 01）. Cervical cancer group＇s IL-10 IOD values were higher than that of the CIN group and the control group and the difference was statistically significant（P〈0. 01）. CIN group＇s IL-10 IOD values were higher than that of the control group and the difference was statistically significant（P〈0. 01）. With the level increasing of CIN,IFN-γ expression showed a trend of weakening and the expression of IL-10 showed a trend of increase and the two comparison between the three groups were statistically significant（P〈0. 01）. With the increase of cervical cancer clinical stage,the expression of IFN-γ showed a trend of weakening and the expression of IL-10 showed a trend of increase and the two comparison between the three groups were statistically significant（P〈0. 01）. HR HPV positive group＇s IFN-γIOD values were lower than those of HR HPV negative groups and the difference was statistically significant（P〈0. 01）.In HR-HPV positive group,IL-10 IOD values were higher than that of the HR-HPV negative groups and the difference was statistically significant（P〈0. 01）. In CIN group,serum levels of IFN-γ CIN group was lower than that before the treatment and serum levels of IL-10 difference was statistically significant（P〈0. 01）. IFN-γ expression was negatively correlated with cervical tissue and CIN grade,clinical stage cervical cancer and HR HPV infection（P〈0. 05）.The expression of IL-10 had a positive correlation with the cervical tissue and CIN grade,clinical stage cervical cancer and HR HPV infection（P〈0. 05）. Conclusion： IL-10 in the cervical tissue in patients with cervical lesions has high expression. IFN-γ shows lower expression in cervical tissue. The expressions of IL-10 and IFN-γ are closely related to the occurrence and progress of cervical lesions and HR-HPV infection. Method of invigorating vital essence can effectively regulate IL-10 and IFN-γ levels.
出处
《中华中医药学刊》
CAS
北大核心
2015年第9期2180-2184,共5页
Chinese Archives of Traditional Chinese Medicine
基金
浙江省卫生厅中医药科学研究基金计划项目(2012ZB144)
