Abstract

Immunosuppressed patients have an increased prevalence of cervical intraepithelial neoplasia (CIN) and apparently normal subjects with CIN have evidence of immunosuppression. The immunosuppression may antedate the cervical lesion or be a result of the CIN. One index of an impaired immune response is a reduced ratio of CD4/CD8 peripheral blood lymphocytes. This study sought to confirm that patients with CIN had a reduced CD4/CD8 ratio and to determine whether local treatment of the cervical lesion affected the abnormality. Patients with CIN had a lower mean CD4/CD8 ratio than controls (1.19 vs. 1.83, P < 0.01) and more of the 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- and post-treatment values in 11 patients confirmed this improvement (mean CD4/CD8: 1.14 vs. 2.08, P < 0.01). These findings confirm an association 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 disease rather than a pre-existing etiologic factor.