The Relevance Of Immunoglobulin In The Vaginal Mucosal Immunity And Persistent Infection Of High Risk Papillomavirus(HR-HPV)

Objective:To study the condition of HPV persistent infection and the changes of concentration of immunoglobulin A 、 G and M in vaginal mucosal immune system.The aim of our study is to discuss the correlation between immunoglobulin A、G、M and HR-HPV persistent infection.Meanwhile, to analyze the high risk factors of HPV persistent infection through investigating study population, thereby to provide theoretical foundation for the early prevention and immunotherapy of cervical cancer.Methods:A cervical cancer screening study was proceeded from August to September,2014 in Tianjin downtown. There were in total 142 women enrolled, including 114 women whose screening results presented HR-HPV infection positive and 28 women whose results presented HR-HPV infection negative. All the women have had accepted the screening test a year ago. All the subjects signed informed consent and accepted the questionnaire. Our screening programs covered Thinprep Cytologic Test and Vaginal lavage fluid. In order to detect HPV infection and genotypes by nest PCR and pyrosequencing technique, and using vaginal lavage fluid to detect the concentration difference of immunoglobulin A 、 G 、 M in the persons of HPV persistent infection and persons of HPV clearance by Enzyme-Linked Immunosorbent Assay. Statistical analysis was calculated by using SPSS 19.0software. It was used to calculate the cut-off value of immunoglobulin concentration by this software. Groups of data were analyzed by using Chi-squared test and the risk factors by using single factor analysis combining logistic regression model.Results:1. The rate of HR-HPV persistent infection was 16.67%,and the clearance rate of HR-HPV was 80.70%.2. The average concentration of immunoglobulin A and G in the group of HR-HPV persistent infection was lower than in the group of HR-HPV clearance, the difference in each group was statistically significant, P<0.05. Moreover the concentration of immunoglobulin M in the group of HR-HPV persistent infection wasclose to the group of HR-HPV clearance, the difference between this two group was not significant, P>0.05.3. The area under the curve of immunoglobulin A and immunoglobulin G was0.652 and 0.604 respectively. The cut-off of immunoglobulin A and immunoglobulin G was 14.40μg/ml and 93.10μg/ml respectively.4. In order to detect HR-HPV infection, the sensitivity of immunoglobulin A and was 64.82% and 63.16%, the specificity was 57.61% and 61.96%, the positive predictive value was 25.00% and 25.53%, the negative predictive value was 89.83%and 89.06%, respectively.5. The menopausal status is the factor of affecting the concentration of IgG, but on the contrary in IgA.6. HPV16 and HPV18 were the most common genotype of HPV persistent infection people, and the percent of them in HPV persistent infection people was52.63% and 26.32%, respectively.7. The peak persistent infection of HR-HPV is at the age between 41 to 45.8. HR-HPV persistent infection was correlated with drinking, no using condoms,sexual frequency.Conclusions:1. The measurement of immunoglobulins in vaginal local immune system can contribute to offer new thought and significant scientific evidence for the immunological treatment of HPV infection, even cervical intraepithelial neoplasia and cervical cancer.2. IgA and IgG can play an important role in vaginal local mucosal immune system. It can be used as the immunological index to distinguish HPV persistent and previous infection.3. HPV DNA genotyping can provide the theory for early screening and immunological treatment of cervical cancer, supply evidence for the prevention,diagnosis, and treatment of cervical cancer at early stage for high risk group.