Cervical cancer is a serious health concern, with China reporting a significant number of new cases and related deaths annually. This cancer is closely linked to the human papillomavirus (HPV), which drives its development and is thought to have an immunogenic nature. The role of immune-inflammatory cells in the progression of HPV-induced cervical lesions is a critical area of study.
In this study, we aimed to investigate the relationship between inflammatory-immune cells and high-grade squamous intraepithelial lesions (HSIL) and to clarify the role of these cells in mediating HPV and HSIL. We enrolled a large group of patients with HSIL and compared them to those with low-grade squamous intraepithelial lesions (LSIL).
Our findings revealed a higher prevalence of multiple HPV infections in patients with HSIL compared to those with a single HPV infection. Multiple HPV infections and a lower CD4/CD8 ratio were identified as independent risk factors for HSIL. Interestingly, the most common HPV genotypes in HSIL patients were HPV-16, HPV-18, and HPV-52.
We discovered that HPV infection, particularly HPV-16 and HPV-52, was partially mediated by the CD4/CD8 ratio, promoting HSIL development. Furthermore, as cervical cancer (CC) progressed, SCC, HPV16, HPV52 infection, and a higher neutrophil-lymphocyte ratio (NLR) were identified as independent risk factors. The top three HPV types in CC patients were HPV-16, HPV-18, and HPV-52.
Our results showed that the relationship between HPV/HPV-16 and CC was partially mediated by NLR, with mediation effect ratios of 1.87% and 2.85%, respectively. These findings highlight the distinct roles of immune-inflammatory cells at different stages of CC progression.
The CD4/CD8 ratio plays a significant mediating role during the HSIL stage, while NLR assumes a major mediating role in the CC stage. This study provides valuable insights into the complex interplay between HPV, immune-inflammatory cells, and cervical lesions, offering potential targets for future research and clinical interventions.
