Research On Correlation Between Human Papillomavirus Type, Local Cell Immunity And AC Subclinical Infection Outcome

Objective: SPI is the main pattern of manifestation of HPV infection,and its outcome involves CA occurrence and relapse, CAepidemiology and occurrence of related malignancy. There is littleresearch data about SPI outcome mechanism at present. In an attemptto explore SPI outcome mechanism, this project aims to study therelation between SPI outcome and HPV infection type of SPI patientsand that between SPI outcome and local cell immunity of hosts, toprovide new ideas for prevention, treatment and monitoring of clinicalHPV infection. Methods:62SPI patients diagnosed by clinical means,acetowhite test, histopathology examination and HPV-DNA detectionare to receive:1. one follow-up visit each month for8months. Thethree outcome results （typical CA, persistent existence of SPI anddisappearance of SPI） are determined by clinical manifestation andacetowhite test and divided into group A, B and C.2. HPV types ofthe62SPI patients are tested by PCR-reverse dot blot, and the relation between HPV type and three outcome results of SPI is analyzed.3.Percentage of T cell subset （CD₄^＋, CD₈^＋, CD₄^＋/CD₈^＋） in skin damagetissue and normal control tissue is tested with immunohistochemistry,and the relation between local cell immunity and three outcomeresults of SPI is analyzed. Result:62out of80SPI patients receivedall the follow-up visits in8months while18failed the visits. Amongthe62SPI patients,20developed into typical CA, accounting for32.3ï¼…;31developed into persistent existence of SPI, accounting for50.0ï¼…; and11developed into disappearance of SPI, accounting for17.7ï¼….2. All the62patients have positive HPV-DNA subtype, and95HPV-DNA subtypes were tested. The positive subtypes are HPV6,11,16,18,42,43,58,59subtypes.42patients were infected with onlyone type,17patients with multiple types,38had low risk and24hadhigh risk. Patients with single position infection and multiple positioninfection in both group A and B have significant comparativedifference （P<0.05）, while the case is different for group C （P＞0.05）.Patients with low risk and high risk in both group A and B also havesignificant comparative difference （P<0.05） while the case is theopposite for group C （P＞0.05）.3. Local CD₄^＋cells in62patients are（44.58±15.79） with CD₄^＋/CD₈^＋ratio （1.30±0.32）, while local CD₄^＋cells in normal tissue are （17.24±7.50） with CD₄^＋/CD₈^＋ratio（1.99±0.69）. The local CD₄^＋cells and CD₄^＋/CD₈^＋ratio in SPI group is normal and there is obvious difference （P<0.05）; CD₈^＋cells in SPIgroup is （34.69±17.21）, while those in normal group is （9.96±6.37）,that is to say, compared with normal group, the SPI group has moreCD₈^＋cells and the difference is significant （P<0.05）. In group A, CD₄^＋cells is （38.39±10.61）, CD₈^＋cells is （36.99±19.18） and the CD₄^＋/CD₈^＋ratio is （1.145±0.347）. In group B, CD₄^＋cells is （44.75±17.30）, CD₈^＋cells is （36.31±17.78） and the CD₄^＋/CD₈^＋ratio is （1.309±0.24）. Thereis no significant difference between the two （P＞0.05）. In group C,CD₄^＋cells is （56.82±12.25）, CD₈^＋cells is （33.75±10.83） and the CD₄^＋/CD₈^＋ratio is （1.53±0.33）; compared with group A and B, it has aobvious difference （P＜0.05）. The differences for all three groups aresignificant compared with the normal group （P＜0.05）. For skindamage of single position, CD₄^＋cells is （47.58±19.10）, CD₈^＋cells is（1.21±0.64） and the CD₄^＋/CD₈^＋ratio is (1.49±0.27; while for that ofmultiple positions, CD₄^＋cells is （38.07±16.43）, CD₈^＋cells is（36.51±10.42） and the CD＋₄^＋/CD8ratio is （34.66±9.47）. Significantdifference exists between the two （P＜0.05）.4. Patients with singleposition infection and multiple position infection in both group A andB have significant comparative difference （P<0.05）, while the case isdifferent for group C （P＞0.05）.5. In group of low risk, CD₄^＋cells is（1.27±0.68）, CD₈^＋cells is （35.28±12.31） and CD₄^＋/CD₈^＋ratio is（1.41±0.78）; in group of high risk, CD₄^＋cells is （38.33±10.56）, CD₈^＋ cells is （36.07±9.62） and CD₄^＋/CD₈^＋ratio is （52.72±18.24）. Thedifference is obvious for both groups （P＞0.05）. Conclusion:1. AsSPI has a high occurrence rate among the people most vulnerable tosexually transmitted disease, it is suggested to give more prominenceto the application of acetic acid test and educate the high risk groups.2. The mixed or single infection of HPV type is related to the SPIoutcome.3. SPI patients are subject to the reduced immunity in partialcells. The strength level of immunity of partial cells is a major factorin determining subclinical symptoms and outcomes. Improving theimmunity of partial cells can help reduce malignant outcome ofdisease.4. The reduced immunity of the partial cells in SPI patients isrelated to the type of the HPV.5. Clinical examination of HPV typeand immunity level of partial cells is of great importance to prognosisevaluation and monitoring of SPI as well as the clinic treatment.