TREATMENT OF CERVICAL INTRAEPITHELIAL NEOPLASIA REVERSES CD4 CD8 LYMPHOCYTE ABNORMALITIES IN PERIPHERAL VENOUS-BLOOD

Immunosuppressed patients have an increased prevalence of cervical int raepithelial neoplasia (CIN) and apparently normal subjects with CIN h ave evidence of immunosuppression. The immunosuppression may antedate the cervical lesion or be a result of the CIN. One index of an impaire d immune response is a reduced ratio of CD4/CD8 peripheral blood lymph ocytes. This study sought to confirm that patients with CIN had a redu ced CD4/CD8 ratio and to determine whether local treatment of the cerv ical lesion affected the abnormality. Patients with CIN had a lower me an CD4/CD8 ratio than controls (1.19 vs. 1.83, P < 0.01) and more of t he patients with CIN had a ratio less than 1.0 [14/38 (37%) vs. 1/30 ( 3%), P<0.01]. After laser treatment of CIN, the mean CD4/CD8 ratio was higher than before treatment (1.76 vs. 1.19, P < 0.01). Paired pre- a nd post-treatment values in 11 patients confirmed this improvement (me an CD4/CD8: 1.14 vs. 2.08, P<0.01). These findings confirm an associat ion between CIN and a reduced CD4/CD8 ratio. The effect on lymphocytes of treating CIN suggests that the altered ratio is a result of the di sease rather than a pre-existing etiologic factor.