An Altered Ratio of CD4+ and CD8+ T Lymphocytes in Cervical Cancer Tissue and Peripheral Blood as a Predictor of Prognostic Outcome: A Clinicopathological Study

Document Type : Research Articles

Authors

1 Department of Radiotherapy, Institute of Post Graduate Medical Education & Research, Kolkata, India.

2 Multidisciplinary Research Unit (MRU), Institute of Post Graduate Medical Education & Research, Kolkata, India.

Abstract

Objective: The aim of our study is to compare CD4+ & CD8+ T lymphocytes in the cervical tumor tissue with those in peripheral blood in patients with carcinoma cervix and to access thier association with known prognostic factors. The study also aims to investigate the association between tumor infiltrating lymphocytes (TILs) and the HPV status of the patients. Methods: In this prospective study, 42 patients with locally advanced squamous cell carcinoma of cervix were included. Percentages of CD4+ and CD8+ T lymphocytes were obtained using flow cytometry-based method from single-cell suspension prepared from simultaneously collected tumor tissue and peripheral blood samples. DNA extracted from tumor tissue was analysed to detect HPV16 (Human Papillomavirus 16) and HPV18 infection. T lymphocyte subsets in blood and tumor tissue were compared. The association of T lymphocytes with known prognostic factors and HPV status of the tumor was examined. Result: Both CD4+ and CD8+ T cells were significantly higher in peripheral blood compared to tumor tissue (p < 0.001). The CD4/CD8 ratio was reversed in tumor tissue compared to peripheral blood due to relatively lower reduction of CD8+ cells compared to CD4+ cells in tumor tissue. No significant association of T lymphocyte subpopulation was found with known prognostic parameters of cervical cancer. CD4+ and CD8+ T lymphocyte infiltration was significantly higher in tumor with HPV16 infection (p < 0.05). A significant alteration of CD4/CD8 ratio was observed for HPV18 positive tumors (p < 0.05). Conclusion: Our study demonstrates that both CD4+ and CD8+ T lymphocyte, which are major component of TILs, are significantly lower in tumor tissue compared to peripheral blood in locally advanced cervical cancer. No association was observed between T lymphocyte subpopulations and major prognostic factors of cervical cancer. The enhanced TILs observed in HPV-associated cervical cancer represents a significant alteration with promising therapeutic applications.

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Asian Pacific Journal of Cancer Prevention
Volume 27, Issue 2
February 2026
Pages 643-649

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History

  • Receive Date: 16 July 2025
  • Revise Date: 22 September 2025
  • Accept Date: 28 January 2026

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