An Altered Ratio of CD4+ And CD8+ T Lymphocytes in Cervical Cancer Tissues and Peripheral Blood – A Prognostic Clue?

Background : Several studies have provided evidence of CD4+ and CD8+ lymphocyte infiltration in various malignancies with probable implications for prognosis. Cervical cancer accounts for a major part of the cancer burden in the developing world. Study of genetically and ethnically diverse Indian cervical cancer patients is necessary to assess effects on lymphocytic infiltration of tumour tissue. Methods : This observational study was conducted over a period of 12 months with selected cervical cancer patients meeting inclusion criteria. Samples of cervical cancer tissue and peripheral blood were obtained and tumour infiltration with CD4+ and CD8+ lymphocytes was noted. Cell numbers were quantified by flow-cytometry and proportions compared between tumour and peripheral blood samples. Results: Tumour infiltration was noted with both CD4+ (13.93±10.95) and CD8+ (19.5±12.05) lymphocyte subtypes. However, compared to peripheral blood, CD4+ cells were significantly less predominant in tumour tissue (p, 0.0013). There was a statistically significant (p, 0.0004) reversal of the ratio of CD4+ and CD8+ in the tumour tissue (0.68±0.39) compared to peripheral blood (1.5±0.66) with maximal alteration in higher stage disease. Conclusion : The study revealed that T lymphocyte infiltration of cervical cancer tissue occurs but the ratio of CD4+ to CD8+ subtypes is sifnificantly lower than in peripheral blood, especially with in advanced stages of disease. The clinical implications of such a reversal of CD4+ and CD8+ ratios is unknown, but might have prognostic significance.