Cervical cancer ranks first among gynecologic malignancies. Neoadjuvant chemotherapy combined with surgery is currently a recommended treatment for locally advanced cervical cancer, however the patient's prognosis is still poor and easy to recur even if the chemotherapy works significantly. We need more effective assessment method for local advanced cervical cancer. Therefore, we evaluated relationship between chemotherapeutic effect and prognosis on the expression of immunological biomarkers including CD4+, CD8+ and Foxp3 pre- and post-neoadjuvant chemotherapy for locally advanced cervical cancer.
CD4+, CD8+ and Foxp3 expression by IHC in 45 cases of locally advanced (IB2-IIB) cervical cancer pre- and post-neoadjuvant chemotherapy, computer software was used to quantitatively analyzed. The relationship between IHC results and clinicopathological characteristics, chemotherapy efficacy, PFS and OS was analyzed by SPSS software.
The expression of CD4, CD8 and Foxp3 in locally advanced cervical cancer before and after neoadjuvant chemotherapy was not related to patients’ age and size of tumor (P > 0.05), which was related to FIGO staging and histological grade. The expression of CD4 and CD8 increased significantly after chemotherapy (P = 0.016, P = 0.009), while the expression of FoxP3 decreased significantly (P = 0.002). There was a significant correlation between the expression of CD8 (P = 0.005), Foxp3 (P = 0.041) and PFS in locally advanced cervical cancer, while CD4 had no significant correlation (P = 0.581). However, there is no significant correlation between OS and CD4 (P = 0.686), CD8 (P = 0.858) and Foxp3 (P = 0.689).
CD4, CD8 and Foxp3 are associated with tumor staging and pathological grading in neoadjuvant chemotherapy for locally advanced cervical cancer, and the expression change of CD8 and Foxp3 before and after chemotherapy can be used as an independent prognostic indicator.
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