The Relationship Between Local Immune Status In Vagina And Hr-HPV Infection And Cervical Lesions

Objectives:By analyzing the expression situation of cytokines,CD4 and CD8 molecules in healthy people and patients with cervical lesions of different grades infected by hr-HPVs to discuss the correlation in local immune status in vagina on hr-HPV infection and cervical lesions of different grades,to provide guiding opinions for the treatment of removing hr.HPV and to provide new ideas for the research of cervical cancer prevention.Methods:From May 2016 to December 2018,62 healthy people(hr-HPV negative and cervical biopsy normal)were selected as the control group from gynecological patients in Yunnan Tumor Hospital.374 hr-HPV positive patients were selected as the experimental group(including 136 cases from hr-HPV subclinical infection group,60 cases from LSIL group,127 cases from HSIL group and 51 cases from cervical cancer group).Vaginal lavage fluid was reserved for the above patients.ELISA was used to detect the contents of cytokines IL-2,IL-4,IL-6,IL-10,TNF-α,IFN-γ,CD4,CD8 molecules.Changes in vaginal cytokine expression in patients with cervical lesions infected with different levels of hr-HPV and their correlation with hr-HPV infection and lesion degrees were observed.Results:1.The contents of IL-6 in vagina of the control group and the experimental group were 38.87(22.39 to 46.41)pg/mL and 42.88(31.16 to 55.04)pg/mL respectively The contents of IFN-γ in vagina were 204.20(128.50 to 251.12)pg/mL and 168.16(123.06 to 229.88)pg/mL respectively.The ratio of IFN-γ/IL-6 in vagina was 5.53(3.30 to 8.34)and 4.08(2.56 to 6.23)respectively.Mann-Whitney U test was used for inter-group comparison.Compared with the control group,the content of IL-6 in vagina of the experimental group increased(P<0.05)and the content of IFN-γ and the ratio of 1FN-γ/IL-6 decreased(P<0.05).2.The contents of IL-2、IL-4,IL-10,TNF-α,CD4,CD8 in vagina of the control group and the experimental group were compared between groups by adopting Mann-Whitney U test.The contents of IL-2,IL-4,IL-10,TNF-α,CD4,CD8 in vagina had no statistical difference(P>0.05).3.The control group and the experimental group were analyzed by single factor Logistic regression.The results showed that intravaginal IL-6 was a risk factor for hr-HPV infection(P<0.05,OR=1.018).intravaginal IFN-γ was a protective factor for hr-HPV infection(P<0.05,OR=0.997).Age and the contents of intravaginal IL-2,IL-4,IL-10,TNF-α,CD4.CDS were not risk factors for hr-HPV infection(P>0.05).4.In the control group,the subclinical group,the LSIL group,the HSIL group and the cervical cancer group,T test was used for comparison between groups.Compared with the control group,the subclinical group and the HSIL group,the content of IL-6 in vagina of the LSIL group was higher(P<0.05).Compared with the subclinical group and the HSIL group,the content of IFN-γ in vagina of the control group was higher(P<0.05).Compared with the LSIL group,the content of the IFN-γ in vagina in the subclinical group was lower(P<0.05).Mann-Whiffiey U test was used for inter-group comparison.Compared with the subclinical group and the HSIL group,the ratio of IFN-γ/IL-6 in control group was higher(P<0.05).5.In the control group,the subclinical infection group,the LSIL group,the HSIL group and the cervical cancer group,there was no significant difference in the contents of IL-2,IL-4,IL-10,TNF-α,CD4 and CD8 in vagina(P>0.05).6.Cervical cancer was regarded as a dependent variable for univariate binomial Logistic regression analysis.The results showed that age was the risk factor for happening cervical cancer(age(P<0.05),OR=1.059).And CD4 molecule in vagina Was the protective factor for happening cervical cancer(P<0.05,OR=0.951).The remaining IL-2,IL-4,IL-10,IFN-γ,TNF-α,CD8 molecules were not risk or protective factors for happening cervical lesions(P>0.05).Conclusions:1.Compared with the experimental group,it can be considered that the expression of IL-6 in vagina increases,the expression of IFN-γ decreases and the ratio of IFN-γ/IL-6 decreases after hr-HPV infection,which reflects the rate of Th1/Th2 decreases and changes in local immune status in vagina may promote the infection of hr-HPV.2.Compared with the experimental group,it can be considered that hr-HPV infection has no correlation with the contents of IL-2,IL-4,IL-10,TNF-α,CD4,CD8 in vagina.3.Compared with the experimental group,it can be considered that decreased expression of IFN-γ and increased expression of IL-6 may be one of the risk factors for hr-HPV infection.4.In comparison between groups,the content of IL-6 in vagina of the LSIL group is higher than that of the control group and the subclinical group,the content of IFN-γ in vagina of the control group is higher than that of the subclinical group and the HSIL group and the ratio of IFN-γ and IL-6 in the control group is higher than that of the subclinical group and the HSIL group,which reflects that after hr-HPV infection,Thl cytokine decreases,Th2 cytokine increases,the rate of Th1/Th2 decreases and Th1 drifts towards Th2.And changes in local immune status in vagina may affect the clearance of hr-HPV and the occurrence of cervical lesions.5.In comparison between groups,the contents of IL-2,IL-4,IL-10,TNF-α,CD4,CD8 in vagina have no correlation with the infection of hr-HPV and the degrees of cervical lesions.6.The decrease of CD4 content in vagina and the increase of age may be one of the risk factors for cervical cancer.7.In comparison between groups,the contents of IL-6 and IFN-γ in vagina do not change with the degree of cervical lesions,so the experimental results cannot reflect whether the contents of IL-6 and IFN-γ in vagina have effect on the degrees of cervical lesions.