A prognostic value of CD45RA+, CD45RO+, CCL20+ and CCR6+ expressing cells as ‘immunoscore’ to predict cervical cancer induced by HPV
Ana Teresa Fernandes, Maria Odete O. Carvalho, Elyzabeth Avvad Portari, Natália Pereira da Rocha, Fábio Bastos Russomano, Eric Henrique Roma, Maria da Glória Bonecini-Almeida
Abstract
Abstract The interplay between cervical cancer (CC) and immune cells, mainly intratumoral lymphocytes, has a pivotal role in carcinogenesis. In this context, we evaluated the distribution of CD45RA + and CD45RO + cells as well as CCR6 + and CCL20 + cells in intraepithelial (IE) and marginal stroma (MS) areas from cervical intraepithelial neoplasia (CIN) I–III, and CC as ‘immunoscore’ for HPV-induced CC outcome. We observed increased CD45RA + and CD45RO + cells distribution in IE and MS areas in the CC group compared to CIN groups and healthy volunteers. Interestingly, there is a remarkable reduction of CCL20 + expressing cells distribution according to lesion severity. The CC group had a significant decrease in CCL20 + and CCR6 + -expressing cells distribution in both IE and MS areas compared to all groups. Using the ‘immunoscore’ model, we observed an increased number of women presenting high CD45RA + /CD45RO + and low CCL20 + /CCR6 + ‘immunoscore’ in the CC group. Our results suggested a pattern in cervical inflammatory process with increasing CD45RA + /CD45RO + , and decreasing CCL20 + /CCR6 + expression in accordance with CIN severity. Taken together, these markers could be evaluated as ‘immunoscore’ predictors to CC response. A more comprehensive analysis of longitudinal studies should be conducted to associate CD45RA + /CD45RO + and CCL20 + /CCR6 + ‘immunoscore’ to CC progression and validate its value as a prognosis method.