Clinical Study On Detection Of Peripheral Blood Lymphocytes In Patients With Cervical Lesions

Objective:The purpose of this study is to explore the immune function status of patients with cervical lesions by comparing the differences of peripheral blood lymphocyte detection indexes between patients with cervical lesions and healthy control groups,and to provide new clinical ideas for monitoring,individualized treatment and prognosis evaluation of cervical lesions.Methods:According to the inclusion and exclusion criteria of this study,118 patients with cervical lesions were randomly selected as the case sample(CS)group,of which cervical squamous intraepithelial lesions(cervical squamous intraepithelial lesions,SIL)82 cases:low-grade squamous intraepithelial lesions(LSIL)31 cases,high-grade squamous intraepithelial lesions(HSIL)51 cases,cervical squamous cell carcinoma,SCC)36 cases:stage I 26 cases,stage II 9 cases,stage IV 1 case;Another 32 women who underwent physical examination during the same period were taken as Healthy control(HC)group.Before physical examination and any treatment,peripheral blood flow cytology test and TCT—HPV-DNA test were performed.Lymphocyte detection includes CD3~+(total T lymphocytes),CD4~+(helper T lymphocytes),CD8~+(inhibitory T lymphocytes),CD4~+/CD8~+,B lymphocytes and NK cells.According to HPV-DNA test results,patients in CS group were regrouped and compared for peripheral blood lymphocyte differences.The results were comprehensively compared and analyzed while the relevant basic clinical data were analyzed.SPSS19.0 and Graphpad Prism8.0 software were used for statistical analysis.The difference was statistically significant with P<0.05.Results:1.Among patients with different cervical lesions,there are statistically significant differences in clinical symptoms such as age,times of pregnancy and childbirth,menopausal status,vaginal bleeding,fluid flow and contact hemorrhage.The age and times of pregnancy and childbirth of SCC patients are higher than those of SIL patients,and clinical symptoms are more common.2.Compared with peripheral blood lymphocyte detection indexes of SIL group,SCC group and HC group,CD3~+cells,CD4~+cells,CD8~+cells and CD4~+/CD8~+ratio have statistical significance.With the aggravation of cervical lesions,CD3~+cells,CD4~+cells,CD4~+/CD8~+ratio show an upward trend,while CD8~+cells show a downward trend.Two-to-two comparisons between groups:Compared with HC group and SIL group,CD3~+cells,CD4~+cells and CD4~+/CD8~+ratio in SCC group increased with statistical significance.3.Comparison of peripheral blood lymphocyte detection indexes between CS subgroups and HC groups:(1)Compared with LSIL group,HSIL group,SCC group and HC group:CD3~+cells,CD4~+cells,CD4~+/CD8~+ratio difference has statistical significance.Two to two comparisons between groups:Compared with HC group and LSIL group,CD3~+cells,CD4~+cells and CD4~+/CD8~+ratio in HSIL group and SCC group increased with statistical significance.Compared with HSIL group,CD3~+cells,CD4~+cells and CD4~+/CD8~+ratio in SCC group were increased,and the difference was statistically significant.Compared with LSIL group,NK cells in HSIL group increased,and the difference was statistically significant.(2)Compared with SIL group,SCC group I,II and HC group:CD3~+cells,CD4~+cells,CD8~+cells and CD4~+/CD8~+ratio have statistical significance.Compared with HC group,CD3~+cells,CD4~+cells and CD4~+/CD8~+ratio in SCC group I and II are increased,and the difference has statistical significance.Compared with SIL group,CD4~+cells and CD4~+/CD8~+ratio in SCC?group ii increased,and the difference was statistically significant.There was no significant difference among the other groups.4.Grade comparison of CD4~+/CD8~+ratio between CS group and HC group:when immune function is inhibited(CD4~+/CD8~+<1.06),the risk of SCC is 1.08 times that of SIL(OR=1.08,95%CI(OR)=0.21-5.60).when immune function is disturbed(CD4~+/CD8~+>2.66),the risk of SCC is 4.73 times that of SIL(OR=4.73,95%CI(OR)=1.31-15.12).The immune function inhibition and immune dysfunction of the body both increase the risk of cervical cancer and are positively correlated with the occurrence and progression of cervical lesions.Compared with OR value,it was found that the risk of immune dysfunction was significantly higher than that of immune suppression.5.Comparison of peripheral blood lymphocyte detection indexes of patients with cervical lesions infected by different HR-HPV:When different types of HR-HPV are infected,there is no significant difference in peripheral blood lymphocyte detection indexes of patients with cervical lesions.There was no significant difference in peripheral blood lymphocyte detection index between different HR-HPV viral loads.Conclusions:1.In patients with different cervical lesions,the age and pregnancy times of patients in SCC group are higher than those of SIL patients,and the corresponding clinical symptoms are more common.2.The cellular immune function of patients with SIL and SCC is disordered to varying degrees.The changes of peripheral blood lymphocyte subsets are related to the grade of cervical lesions.With the progression of cervical lesions,the shift of lymphocyte subsets in patients is more obvious.No obvious shift of B cells and NK cells is found,while the shift of T lymphocyte subsets is more obvious.3.With the aggravation of cervical lesions,peripheral blood CD3~+cells,CD4~+cells,CD4~+/CD8~+ratio gradually increased,CD8~+cells decreased.Cellular immune dysfunction may increase the risk of cervical lesions and may be an effective clinical reference index for evaluating cervical lesions.4.There was no significant difference in peripheral blood lymphocyte detection indexes of patients with HR-HPV infection,indicating that the immune cell changes in patients with cervical squamous intraepithelial lesions may not be related to high-risk human papillomavirus infection,but large sample data are still needed to support this conclusion.