2009 年第 19 卷第 11 期 CHINA ONCOLOGY 2009 Vol.19 No.11 831 免疫球蛋白 G(immunoglobulin G,IgG) 是血清和细胞外液中含量最高的免疫球蛋白, 其某个亚类的升高, 可能与宫颈上皮内瘤变 (cervical intraepithelial neoplasia, CIN) 的发生 发展及转归有密切相关 然而对于 CIN 患者血清人乳头瘤病毒样颗粒 (human papillomavirus virus-like particles, HPV VLPs)IgG1 及 IgG2 抗体变化目前尚不明确 本研究旨在探讨 CIN 患者血清中 HPV16VLPs-IgG1 IgG2 亚类抗体的变化及其与不同级别宫颈病变的关系 采用 ELISA 法检测 HPV 感染患者 HPV 感染患者 CIN 患者及子宫平滑肌瘤或宫颈炎患者血清中 HPV16VLPs-IgG 和 HPV16VLPs-IgG1 IgG2 亚类抗体的表达水平 患者血清中 HPV16VLPs-IgG 和 IgG1 抗体含量随宫颈病变级别增高而增加, 差异有统计学意义 (P<0.05) 对照组 HPV 感染组和 CINⅠ 组中以 IgG2 抗体为主 (IgG2/IgG1>1), 分别为 100.00% 87.50% 和 75.00%, 而 CINⅡ~Ⅲ 组中仅为 9.52%, 与前 3 组相比, 差异有统计学意义 (P<0.05) HPV16-DNA 阳性组的 HPV16VLPs- IgG IgG1 IgG2 阳性率及吸光度 A 值明显高于非 HPV16-DNA 阳性组, 差异有统计学意义 (P<0.05) HPV16- DNA 检测与血清 HPV16VLPs-IgG 抗体检测之间呈中度相关 (r=0.531,p<0.05) 宫颈癌前病变尤其是 CINⅡ~Ⅲ 患者血清 HPV16VLPs-IgG 及其亚类表达增高, 可能与病毒持续时间 病变严重程度有关 ; 机体感染 HPV 后, 低级别宫颈病变组 对照组血清 HPV16VLPs-IgG2 抗体表达增高 (IgG2/IgG1>1), 可能与 HPV 清除和宫颈病变逆转有关 宫颈上皮内瘤变 ; IgG1 IgG2 亚类 ; 酶联免疫吸附试验 R737.33 A 1007-3639(2009)11-0831-05 The association between IgG1, IgG2 subclasses toward human papillomavirus16-like particles in the serum and cervical intraepithelial neoplasia HAN Ling,LI Hai-rong,ZHANG Bing-yi,ZUO Manzhen,XUE Yue-zhen,ZHANG Jun (Department of Obstetrics and Gynecology,First People s Hospital of Yichang,Yichang Hubei 443000,China) Correspondence to:han Ling E-mail:ziling_520@sina.com [Abstract] Background and purpose:the maximum content of immunoglobulin G was found in serum and extracellular fluid. The increase of some immunoglobulin G subclasses may closely correlate with the occurrence, development and the outcome of cervical lesions. However, the changes of IgG subclasses toward human papillomavirus 16-like particles (HPV16VLPs) in the serum of patients are still under investigation. This paper aimed to study this issue and also analyze the relationship between the expression of IgG subclasses and different grades of cervical lesions. Methods:The expression of IgG subclasses in 32 human papillomavirus, 30 cervical intraepithelial neoplasia (CIN ), 43 CIN -, 24 hysteromyoma and chronic cervicitis were examined by ELISA. Results:The absorbance value of HPV16-IgG, IgG1 increased with the grade of CIN (P<0.05). The IgG2 dominance (IgG2/IgG1 ratio>1) from control group was 100%, 87.50% for HPV infection group, 75% for CIN group, compared with that from CIN - patients (9.52%) (P<0.05). The positive rate and absorbance value of HPV16-IgG, IgG1, IgG2 from HPV16-DNA positive group were significantly higher than those from non-hpv16-dna positive group (P<0.05). There was a moderate correlation between the HPV16-DNA testing and detection of HPV16-IgG. Conclusion:An 通讯作者 : 韩玲 E-mail:ziling_520@sina.com
832 韩玲, 等. CIN 患者血清 HPV16 病毒颗粒 IgG1 IgG2 亚类抗体变化及临床意义 increase of the expression of HPV16-IgG and its subclasses in the serum of the patients with cervical precancerous lesions, especially those with CIN -, might be associated with duration of HPV infection and severity of cervical lesions. An increase of the IgG2 dominance (IgG2/IgG1>1) in serum from low grade cervical lesions group and normal control group, might indicate the clearance of HPV infection and the regression of cervical lesions. [Key words] cervical intraepithelial neoplasia; IgG1 and IgG2 subclasses; ELISA A A A
2009 年第 19 卷第 11 期 833 A AA t χ P P P P A A P P A P Tab. 1 Comparison of detection results of serum HPV16VLPs-IgG antibodies in each group Cases HPV16 VLPs positive expression n(%) x±s Ig G A value Study group 105 37(35.24) HPV 32 8 (25.00) 0.485±0.037 CIN 30 8 (26.67) 1.531±0.013 CIN - 43 21 (48.84) 2.421±0.012 Control group 24 2 ( 8.33) 0.328±0.017 P P P A A P P A P P P A P A P AA P A A P P P
834 韩玲, 等. CIN 患者血清 HPV16 病毒颗粒 IgG1 IgG2 亚类抗体变化及临床意义 P A P r P Tab. 3 Relationship between IgG2/IgG1 ratio and all levels of cervical lesions Expression number IgG2/IgG1>1 n(%) Study group HPV 8 7(87.50) CIN 8 6(75.00) CIN - 21 2(9.52) Control group 2 2(100.00) Tab. 2 Comparison of detection results of serum HPV16VLPs- IgG1, IgG2 antibodies in each group n HPV16 VLPs-IgG1 HPV16 VLPs-IgG2 Positive expression n(%) A value Positive expression n(%) A value Study group 105 31(29.52) 31(29.52) HPV 32 6(18.75) 0.311±0.020 8(25.00) 0.551±0.042 CIN 30 7(23.33) 1.104±0.029 6(20.00) 1.686±0.013 CIN - 43 18(41.86) 1.941±0.038 17(39.53) 1.831±0.064 Control group 24 2(8.33) 0.308±0.019 2(8.33) 1.611±0.021 x±s Tab. 4 Comparison of detection results of HPV16-DNA and HPV16VLPs-IgG, IgG1, IgG2 antibodies n HPV16 VLPs-Ig G HPV16 VLPs-Ig G1, Ig G2 Positive expression n(%) A value Positive expression n(%) A value HPV16-DNA(+) 35 26(74.29) 1.564±0.062 26(74.29) 1.365±0.037 Non-HPV16-DNA(+) 70 11(15.71) 0.453±0.016 5(7.14) 0.351±0.022
2009 年第 19 卷第 11 期 835 A A A