Abstract

Introduction: B lymphocyte, macrophage and mast cell densities in the stroma underlying cervical low and high grade squamous intraepithelial lesions (LSIL and HSIL) and squamous cell carcinoma (SCC) in 200 tissue samples, with concomitant HPV typing, was assessed, in order to examine their relationship to disease status and progression.

Methods: Sections from 215 cervical specimens (149 LSIL, 38 HSIL, 13 SCC and 15 normal cervical mucosae) were immunostained for B lymphocytes (CD20), macrophages (CD68) and mast cells (CD117). The number of cells per high power field (henceforth called density) in the stroma underlying epithelial lesions was assessed. Statistical analysis was performed using four ordinal scale groups of increasing severity (normal, LSIL, HSIL and SCC).

Results: Densities of all three cell types had a statistically significant, proportional correlation to disease severity, more so for B lymphocytes. Increased density of any cell type is linked to an increase in the densities of the remaining two. A statistically significant difference in B lymphocyte and mast cell density was found between LSIL and HSIL. No cell type density was found to be predictive of the outcome of LSIL. No relationship with HPV type was found.

Discussion:Increased B lymphocyte and mast cell density in the stroma underlying cervical HSIL and SCC compared to LSIL suggests a possible relationship of both cell types to progression of cervical SIL. No predictive value of the density of any cell type was found concerning the outcome of LSIL. Immunohistochemistry may contribute to elucidate the relationship of local immunity effector cells to cervical epithelial lesions.

Keywords: HPV; SIL; B-lymphocyte; Mast cell; Macrophage