CAJ | 학술논문

目的探讨尖锐湿疣患者外周血T细胞亚群及NK细胞水平及其与尖锐湿疣临床复发的关系.方法用免疫荧光法检测杭州市第一人民医院就诊的94例尖锐湿疣病例和50例正常对照组外周血中T细胞亚群及NK细胞水平,C02激光清除病例疣体后每2周复查1次,随访持续12周,并统计复发率和复发次数,并比较复发和未复发病例、不同型别HPV患者外周血T细胞亚群水平.结果病例总体复发率为65.96％ (62/94),平均复发次数为2.23次.尖锐湿疣病例外周血CD4+T细胞占(32.41±8.14)％,低于对照组(t=4.52,P＜0.01);CD8+T细胞占(31.56±7.95)％,高于对照组(t=5.44,P＜0.01);NK细胞占(19.86±6.29)％,低于对照组(t=2.12,P＜0.05).与尖锐湿疣未复发病例相比,复发病例外周血CD8+T细胞较高,占(33.64±7.71)％;而CD4/CD8比值较低,为(0.97±0.31),差异均有统计学意义(t=3.79、4.34,P均＜0.01).与HPV16/18单一型别感染和HPV6/11/16/18型合并感染病例相比,HPV6/11单一型别感染病例外周血CD8+T细胞水平较低、CD47CD8+比值较高(q=3.37～3.45,P均＜0.05).结论尖锐湿疣患者存在细胞免疫缺陷,而高危型HPV感染病例有更高的免疫缺陷风险.CD8+T细胞水平和CD4+/CD8+比值有助于判断尖锐湿疣预后.
목적 탐토첨예습우환자외주혈T세포아군급NK세포수평급기여첨예습우림상복발적관계.방법 용면역형광법검측항주시제일인민의원취진적94례첨예습우병례화50례정상대조조외주혈중T세포아군급NK세포수평,C02격광청제병례우체후매2주복사1차,수방지속12주,병통계복발솔화복발차수,병비교복발화미복발병례、불동형별HPV환자외주혈T세포아군수평.결과 병례총체복발솔위65.96％ (62/94),평균복발차수위2.23차.첨예습우병예외주혈CD4+T세포점(32.41±8.14)％,저우대조조(t=4.52,P＜0.01);CD8+T세포점(31.56±7.95)％,고우대조조(t=5.44,P＜0.01);NK세포점(19.86±6.29)％,저우대조조(t=2.12,P＜0.05).여첨예습우미복발병례상비,복발병예외주혈CD8+T세포교고,점(33.64±7.71)％;이CD4/CD8비치교저,위(0.97±0.31),차이균유통계학의의(t=3.79、4.34,P균＜0.01).여HPV16/18단일형별감염화HPV6/11/16/18형합병감염병례상비,HPV6/11단일형별감염병예외주혈CD8+T세포수평교저、CD47CD8+비치교고(q=3.37～3.45,P균＜0.05).결론 첨예습우환자존재세포면역결함,이고위형HPV감염병례유경고적면역결함풍험.CD8+T세포수평화CD4+/CD8+비치유조우판단첨예습우예후.
Objective To evaluate the variation of peripheral blood T lymphocyte subsets and NK cells of patients with condyloma acuminatum (CA),and the relationship with the clinical recurrence rate.Methods Peripheral blood T lymphocyte subsets and NK cells of 94 CA cases and 50 normal controls of patients from Hangzhou First People's Hospital were detected by immunofluorescence method.The cases whose warts were cleared by using CO2 laser,observed the therapeutic effect per two weeks.The rate and the times of recurrence were examined after 12-week follow-up.The peripheral blood T lymphocyte subsets levels of different patients and types of HPV were compared.Results After 12-week follow-up,the rate and the average times of recurrence were 65.96％(62/94)and 2.23 in all of the CA cases.The CD4+T cell percentage in CA cases was (32.41±8.14)％,lower than that in control group (t=4.52,P＜0.01); the CD8+T cell accounted for (31.56±7.95)％,higher than control group (t=5.44,P＜0.01); NK cells accounted for (19.86±6.29)％,also lower than control group (t=2.12,P＜0.05).Compared with the CA cases without recurrence,the CD8+T cell in recurrence ones were higher,accounted for (33.64±7.71)％ (t=3.79,P＜0.01); the CD4+/CD8+ cell ratio was lower (0.97±0.31,t=4.34,P＜0.01).The level of CD8+T cell percentage in the cases infected with sole HPV6/11 genotype,was lower than HPV6/11/16/18 genotype coinfected cases,or sole HPV16/18 genotype infected ones(q=3.45 and 3.37,P＜0.05).The CD4+/CD8+ cell ratio in the sole HPV6/11 genotype infected ones was higher than HPV6/11/16/18 genotype coinfected or sole HPV16/18 genotype infected ones (q=3.38 and 3.38,P＜0.05).Conclusions The cell-mediated immunity exists in the patients wwith CA,and the high-risk HPV genotype infection patients have higher probability of cell-mediated immunity.The level of CD8+T cell percentage and CD4+/CD8+ cell ratio can be the helpful molecular biomarkers in risk assessment of recurrence and prognostic prediction.