A prognostic value of CD45RA+, CD45RO+, CCL20+ and CCR6+ expressing cells as 'immunoscore' to predict cervical cancer induced by HPV

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.