Role of Stromal CD25+/CD8+ Lymphocyte Ratio in Patients With Grade 2-3 Cervical Intraepithelial Neoplasia (CIN 2-3): A Retrospective Single-center Study

ENRICO SIMONETTI & LAVINIA DOMENICI et al.

This study aimed to assess the role of the stromal CD25+/CD8+ (Cluster of Differentiation) lymphocyte ratio and other immunohistochemical markers in predicting the risk of recurrence and human papillomavirus (HPV) persistence after Loop Electrosurgical Excision Procedure (LEEP) conization in patients with grade 2-3 cervical intraepithelial neoplasia (CIN2-3). A retrospective analysis was conducted on 72 patients who underwent LEEP for CIN2-3 in our Department. Criteria for enrollment included HPV genotyping before and after surgery and a follow-up time ≥18 months. Immunohistochemical analysis assessed CD8+ cytotoxic T cells and CD25+ regulatory T cells in the cervical stroma, and the CD25+/CD8+ ratio was computed. Recurrence of CIN2-3 and HPV persistence after LEEP were the endpoints of the study. CIN2-3 recurrence occurred in 13.9% of patients with smoking, HPV-16/18 infection, positive surgical margins, and CIN3 histology being significant risk factors. A CD25+/CD8+ ratio >1.25 was associated with a shorter disease-free survival (DFS) ( The CD25+/CD8+ ratio is a promising biomarker for identifying patients at higher risk of CIN2-3 recurrence and HPV persistence post-LEEP. These findings highlight the role of immune profiling in the management of patients affected by CIN2-3 and support the integration of vaccination and personalized follow-up strategies.
Authors
ENRICO SIMONETTI, SABINA PISTOLESI, AMERIGO FERRARI, MATTEO DELLA ROSA, FEDERICA MEI, FEDERICO DI COCCO, FABIO TAPONECO, STEFANIA COSIO, ALESSANDRO BONUCCELLI, ANGIOLO GADDUCCI, TOMMASO SIMONCINI, PIETRO BOTTONE, ANTONIO GIUSEPPE NACCARATO, LAVINIA DOMENICI