宫颈癌患者高危型人乳头瘤病毒感染与免疫功能和癌基因表达的相关性

目的 探讨宫颈癌患者高危型人乳头瘤病毒（HPV）感染的检测及其与免疫功能和癌基因表达的相关性。方法 选择2017年9月至2018年12月在我院接受手术治疗的118例原发性宫颈癌患者为宫颈癌组，根据高危型HPV感染情况进一步分为高危型HPV组（89例）和非高危型HPV组（29例）。选择同期在我院行子宫全切术的57例子宫肌瘤患者为子宫肌瘤组。对比各组患者外周血T淋巴细胞亚群分布情况，病灶组织中原癌基因（E6/E7、c-Met、SALL4、PGRN）和抑癌基因（p53、pRb、PTEN、LKB1）表达量的差异。结果 宫颈癌组患者病灶组织中高危型HPV感染率显著高于子宫肌瘤组（75.42% vs 22.81%，2=43.764，P＜0.05）。高危型HPV组患者外周血中CD4+ T淋巴细胞比例、CD4+T/CD8+ T比值低于非高危型HPV组，CD8+ T淋巴细胞比例高于非高危型HPV组（均P＜0.05）。高危型HPV组患者病灶组织中E6/E7、c-Met、SALL4、PGRN mRNA的表达量高于非高危型HPV组，而p53、pRb、PTEN、LKB1 mRNA的表达量低于非高危型HPV组（均P＜0.05）。结论 高危型HPV感染可导致宫颈癌患者细胞免疫功能下降及肿瘤恶性程度增加，可能是导致病情恶化、治疗效果不佳的危险因素之一。

The correlation between high-risk HPV infection and immune function and oncogene expression in patients with cervical cancer

Abstract: Objective To investigate the rate of high-risk HPV infection in patients with cervical cancer and its correlation with immune function and oncogene expression. Methods A total of 118 patients with primary cervical cancer who underwent surgery in our hospital during September 2017 to December 2018 were included and divided into the high-risk HPV group(n=89) or non-high-risk HPV group(n=29) according to whether with or without high-risk HPV infection. 57 hysteromyoma patients who underwent total hysterectomy during the same period were included as the hysteromyoma group. The distribution of T lymphocyte subsets in peripheral blood and expressions of proto-oncogenes(E6/E7, c-Met, SALL4, PGRN) and anti-oncogenes(p53, pRb, PTEN, LKB1) in the lesions were compared between groups. Results The infection rate of high-risk HPV in cervical cancer patients was significantly higher than that in hysteromyoma group(75.42% vs 22.81%, 2=43.764, P<0.05). The proportion of CD4+ T lymphocyte and ratio of CD4+T/CD8+ T in high-risk HPV group were lower than those in non-high-risk HPV group, while the proportion of CD8+ T lymphocyte was higher than that in non-high-risk HPV group(P<0.05). The expressions of E6/E7, c-Met, SALL4 and PGRN in high-risk HPV group were higher, while the expressions of p53, pRb, PTEN and LKB1 were lower than those in non-high-risk HPV group(all P<0.05) respectively. Conclusion High-risk HPV infection can decrease the cellular immune function and increase the malignancy of cervical cancer, which may be one of the risk factors leading to deterioration of the disease and poor therapeutic effect.