Objectives The relationship of Treg and CD4+IL-21+ or CD4+IL-22+ in the peripheral blood and the tissue of the epithelial ovarian tumor, to blood serum levels of markers HE4 and CA125 and to assess the application of the risk of ovarian malignancy algorithm (ROMA).
Methods Mononuclear cells (PBMCs) obtained from the peripheral blood and the ovarian tissue of patients suffering from ovarian pathology were isolated by density gradient centrifugation. The control group consisted of patients who had undergone surgery for unexplained infertility. The percentage of Treg and Th17 producing IL-21+ or IL-22+ lymphocytes in peripheral blood and tissue was assessed using the flow cytometry method according to the manufacturer’s instructions. The ROMA index was calculated by way of levels of HE4 and CA125 in serum.
Results A negative correlation was also found in the percentage of CD4+/IL-21+ in the peripheral blood and the amount of Treg infiltrating normal ovarian tissue. Moreover, we observed a relationship between the ROMA percentage in the serum and Treg in the peripheral blood of women suffering from benign ovarian tumors.
Conclusions In patients with benign tumors, we found for the first time, significant negative correlation between percentages of circulating Treg cells in the peripheral blood and with ROMA assessment in the serum. This result could be explained by the negative influence of Treg on inflammation and secondary on malignancy induced by chronic inflammation. Furthermore, the imbalance in Treg percentage in normal ovarian tissue of patients suffering from unexplained infertility, could induced immunotolerance, and hence, infertility
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