Abstract
BackgroundAlterations in peripheral blood lymphocytes in cervical cancer have been reported, although conflicting views exist. The present study investigated the distributions of lymphocyte subsets in tumor tissue and peripheral blood samples from cervical cancer patients and precancerous lesion patients, and evaluated the correlations of lymphocyte subsets with clinicopathological and prognostic variables.MethodsA total of 44 patients with stage IB1-IIA2 cervical cancer and 13 precancerous lesion patients were included. Lymphocytes were collected from the tumor tissue and the peripheral blood, and isolated by Lymphoprep density gradient centrifugation. The percentages of lymphocyte subsets were quantified by flow cytometry analysis, and the differences between lymphocyte subsets in the tumor tissue and peripheral blood were compared by SPSS. In addition, the relationships between lymphocyte subsets and clinicopathological and prognostic variables were analyzed.ResultsOur results revealed that the amount of total T lymphocytes, CD8+ T cells, granulocytes, pDCs, CD16+ monocytes and CD56high NK cells were significantly higher in the tumor tissue than in the peripheral blood in the cervical cancer patients, while those of CD4+ T cells, CD4+/CD8+ cell ratio, rdT cells, BDCA1+ mDCs, total monocytes, CD14+ monocytes, NK cells and CD56low NK cells exhibited the opposite trend (p < 0.05). The levels of total pDCs and BDCA1+ mDCs in the peripheral blood were significantly lower in the cervical cancer patients than in the precancerous lesion patients, while the proportion of CD16+ monocytes was elevated (p < 0.05). In addition, some lymphocyte subsets, especially CD4+ cells and CD8+ cells, and the CD4+/CD8+ cell ratio were closely associated with clinicopathological and prognostic parameters.ConclusionsThese results suggested that distinct alterations in infiltrating lymphocyte subsets occurred in the tumor and were associated with clinicopathological and prognostic parameters. Systemic impairment of the immune system may occur in the antitumor response of cervical cancer patients.
Highlights
Alterations in peripheral blood lymphocytes in cervical cancer have been reported, conflicting views exist
The results showed that the percentages of total plasmacytoid dendritic cells (pDCs) and BDCA1+ myeloid dendritic cells (mDCs) were significantly lower in the cervical cancer patients than in the precancerous lesion patients; the CD16+ monocyte and CD56low Natural Killer cells (NK) cell proportions were higher in the cervical cancer patients than in the precancerous lesion patients, and the differences were significant between the cervical cancer patients and precancerous lesion patients (p < 0.05) (Table 3)
Tumor size and lymphovascular space invasion (LVSI) status are closely related to the distributions of lymphocytes in the peripheral blood In the analysis of the peripheral blood, the results showed that the CD16+ monocyte proportion was significantly lower in the age ≤ 47 group than in the age > 47 group (p < 0.05) (Table 4)
Summary
Alterations in peripheral blood lymphocytes in cervical cancer have been reported, conflicting views exist. Colleagues from France characterized T cells (CD4+, CD8+, CD45 RO+) by immunohistochemistry in high-risk HPV-infected cervical cancers and premalignant lesions [8]. Das et al assessed peripheral blood lymphocyte subpopulations in cervical cancer patients among Indian women, including only five parameters (CD4+ helper T cells, CD8+ cytotoxic T cells, CD16+ cells, CD19+ cells and CD56+ cells) [5]. Another interesting publication described systemic T cell responses to HPV 16 and HPV 18 proteins [11]. We found that regulatory T cells were increased in the patients with cervical intraepithelial neoplasia or cancer [16]
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