CD4 LYMPHOCYTES IN WOMEN WITH INVASIVE AND PREINVASIVE CERVICAL NEOPLASIA

Objective. To assess the relationship between CD4 lymphocyte populatio n and stage of disease in cervical neoplasia. Methods. Study populatio n was 107 women with invasive cervical cancer, 116 women with cervical intraepithelial neoplasia (GIN), and 32 women without neoplasia diagn osed in 1988-1994. All women under age 50 were seronegative for the hu man immunodeficiency virus (HIV). All women over age 50 with CD4:CD8 r atio below normal were HIV-negative. Stage was defined by FIGO criteri a using clinical findings. CD4 and CD8 lymphocyte populations were enu merated by flow cytometry prior to treatment. The normal range of CD4 counts was defined as 537-1571 cells/mm(3). Results. Distribution of C D4 count was similar in stages I (n = 40), II (n = 24), and III (n = 3 2), with 31% below normal and 9% above normal (mean CD4 count = 881). However, in stage IV (n = 11), 64% were below normal and 18% above nor mal (mean CD4 = 591). The difference in distribution between stages I- III and stage IV was statistically significant. Among 116 CIN patients , 10% had CD4 counts below normal and 3% above normal (mean CD4 = 910) . Among 32 women without cervical neoplasia, 0% had CD4 counts below n ormal and 3% above normal. The difference between CIN and invasive can cer in the distribution of CD4 counts and CD8 counts was significant ( P < 0.01). There was no difference in the CD4 count distribution by CI N severity. Forty-five percent of patients with below-normal CD4 count s at diagnosis developed recurrent cancer compared to 43% of patients with normal or above-normal CD4 counts. Conclusion. Women with invasiv e cervical cancer have lower CD4 counts and a broader distribution com pared to women with preinvasive or no neoplasia. Metastatic cancer at diagnosis was associated with severely depressed CD4 count. (C) 1995 A cademic Press, Inc.